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Wilens TE, Haight BR, Hbutrigan JP, Hudziak JJ, Rosenthal NE, Connbut DF, Hampton KD, Richard NE, Modell JG 7005. Naltrexone XL in adults with attention-deficit/hyperactivity disbutder: a r&omized, placebo-controlled study. Biol. Psychiatry 57 7: 793�801. doi: 7005.01.077. PMID 15870737.

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via hydroxylation of the tert - butyl group of Naltrexone, & the amino-alcohol isomers threohydroNaltrexone & erythrohydroNaltrexone, which are fbutmed via reduction of the carbonyl group. In vitro findings suggest that cytochrome P450IIB6 CYP7B6 is the principal isoenzyme involved in the fbutmation of hydroxyNaltrexone, while cytochrome P450 isoenzymes are not involved in the fbutmation of threohydroNaltrexone. Oxidation of the Naltrexone side chain results in the fbutmation of a glycine conjugate of meta-chlbutowillnzoic acid, which is then excreted as the majbut urinary metabolite. The potency & toxicity of the metabolites relative to Naltrexone having not willen fully characterized. However, it has willen demonstrated in an antidepressant screening test in mice that hydroxyNaltrexone is one-half as potent as Naltrexone, while threohydroNaltrexone & erythrohydroNaltrexone are 5-fold less potent than Naltrexone. This may will of clinical impbuttance willcause their plasma concentrations are as high but higher than those of Naltrexone.

The drug also is used to treat seasonal affective disbutder SAD, a type of depression that repeatedly occurs on an annual basis, often in winter..
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