How to Treat Opiate Withdrawal in Neonates
- Conditions
- Neonatal Abstinence Syndrome
- Interventions
- Registration Number
- NCT02810782
- Lead Sponsor
- University of Zurich
- Brief Summary
Three different drugs are used in a randomised, double blind, clinical multi-centre trial with three arms. Major objective is to investigate the duration of drug treatment based on the Finnegan score. Secondary objectives are to document weight gain, the need for adding a second drug when the first drug is not effective enough and possible side effects such as convulsions.
- Detailed Description
Background: Neonatal narcotic abstinence syndrome is an important medical, social and financial problem. Several drugs are used to treat the withdrawal symptoms in neonates that have been exposed to opiates in utero, but there is no consensus which one is best.
Goal: Three different drugs are used in a randomised, double blind, clinical multi-centre trial with three arms. Major objective is to investigate the duration of drug treatment based on the Finnegan score. Secondary objectives are to document weight gain, the need for adding a second drug when the first drug is not effective enough and possible side effects such as convulsions.
Methods: Neonates born after 34 completed weeks of gestation with meconium proven antenatal opiate exposure and parental informed consent are included. Infants with severe malformation are excluded. Each infant is assessed every eight hour by a modified Finnegan score. When 9 points are exceeded drug treatment is started and dose increased stepwise according to the score. The masqued solution applied orally contains morphine, phenobarbital or chlorpromazine. When the maximum dose does not reduce the score, a second randomisation and one of the two remaining drugs is added, again in a blinded way.
A total of 120 infants, 40 in each group will be included in the study.
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 120
- Neonates of mothers who consumed opiates during pregnancy
- Born after 34 completed weeks of pregnancy
- Parents' informed consent
- Preterm birth before 34 0/7 gestational weeks
- Severe malformation
- Illness requiring respiratory assistance or catecholamines
- Negative meconium drug test
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Chlorpromazine Chlorpromazine Chlorpromazine loading dose 0.5 mg/kg body weight maintenance dose 0.25 mg/kg every 4 hours Phenobarbital Phenobarbital Phenobarbitone loading dose 10 mg/kg body weight maintenance dose 0.83 mg/kg body weight every 4 hours Morphine Morphine Morphine (tinctura opii) 0.25 mg/kg body weight every 4 hours
- Primary Outcome Measures
Name Time Method Duration of treatment 0 to 42 days Treatment is reduced stepwise until withdrawal symptoms have gone
- Secondary Outcome Measures
Name Time Method Treatment failures (need for adding second medication) through study completion, up to 10 weeks Need for additional drug if investigational drug does not control withdrawal symptoms
Weight gain through study completion, up to 10 weeks Incidence of convulsions Whole time of hospitalisation (up to 10 weeks)