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Mannaioni, Guido; Lanzi, Cecilia; Lotti, Michela; Galli, Valentina; Totti, Arianna; Pacileo, Ilaria; Sili, Maria; Pracucci, Chiara; Dilaghi, Arianna; Bertieri, Lara; Quaranta, Mariarita; Orsini, Francesco; Occupati, Brunella; Michahelles, Assia; Ciuti, Riccardo; Bianchini, Elisa; Fabbro, Giancarlo; Biggeri, Annibale; Masini, Emanuela; Moroni, Flavio

Methadone Dose Adjustments, Plasma R-Methadone Levels and Therapeutic Outcome of Heroin Users: A Randomized Clinical Trial

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  • Medientyp: E-Artikel
  • Titel: Methadone Dose Adjustments, Plasma R-Methadone Levels and Therapeutic Outcome of Heroin Users: A Randomized Clinical Trial
  • Beteiligte: Mannaioni, Guido; Lanzi, Cecilia; Lotti, Michela; Galli, Valentina; Totti, Arianna; Pacileo, Ilaria; Sili, Maria; Pracucci, Chiara; Dilaghi, Arianna; Bertieri, Lara; Quaranta, Mariarita; Orsini, Francesco; Occupati, Brunella; Michahelles, Assia; Ciuti, Riccardo; Bianchini, Elisa; Fabbro, Giancarlo; Biggeri, Annibale; Masini, Emanuela; Moroni, Flavio
  • Erschienen: S. Karger AG, 2018
  • Erschienen in: European Addiction Research
  • Sprache: Englisch
  • DOI: 10.1159/000485029
  • ISSN: 1022-6877; 1421-9891
  • Schlagwörter: Psychiatry and Mental health ; Health (social science) ; Medicine (miscellaneous)
  • Entstehung:
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  • Beschreibung: <jats:p>&lt;b&gt;&lt;i&gt;Aims:&lt;/i&gt;&lt;/b&gt; We aimed to improve the retention in treatment and therapeutic outcome of methadone maintenance treatment (MMT) patients by adjusting the oral methadone dose in order to reach a “target” plasma R-methadone level (80–250 ng/mL). &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; A multicenter randomized controlled trial was organized. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; The intention-to-treat statistical analysis showed that repeated dose adjustments performed in order to obtain therapeutic plasma R-methadone levels did not improve retention in treatment of heroin-dependent patients. However, patients having plasma methadone levels in the “target range” at the beginning of the study had a better retention in treatment than controls. Furthermore, patients succeeding in keeping plasma R-methadone target levels (per protocol analysis) remained in treatment and improved their social scores better than controls. ­&lt;b&gt;&lt;i&gt;Conclusion:&lt;/i&gt;&lt;/b&gt; Although the primary endpoint of this study was not demonstrated, a post hoc and a per protocol analysis suggested that patients in MMT with plasma R-methadone concentrations in the target range have a better therapeutic outcome than controls.</jats:p>