Historique
Périodique
Evaluation of levo-alpha-acetylmethdol (LAAM) as an alternative treatment for methadone maintenance patients who regularly experience withdrawal : a pharmacokinetic and pharmacodynamic analysis
(Le LAAM : traitement alternatif pendant la maintenance à la méthadone chez des patients qui expérimentent régulièrement le sevrage. Une analyse pharmacocinétique et pharmacodynamique)
Auteur(s) :
NEWCOMBE, D. A. L. ;
BOCHNER F. ;
WHITE, J. M. ;
SOMOGYI A. A.
Année
2004
Page(s) :
63-72
Langue(s) :
Anglais
Refs biblio. :
41
Domaine :
Drogues illicites / Illicit drugs
Thésaurus mots-clés
METHADONE
;
LAAM
;
RETENTION
;
TRAITEMENT DE MAINTENANCE
;
COMPARAISON
;
EFFICACITE
Note générale :
Drug and Alcohol Dependence, 2004, 76, (1), 63-72
Note de contenu :
graph. ; tabl.
Résumé :
ENGLISH :
The aim of this study was to determine if substitution of daily methadone with second daily levo-alpha-acetylmethadol (LAAM) would convert non-holders on methadone into holders on LAAM, and to compare plasma concentrationtime profiles of (R)-methadone with LAAM and its two metabolites. Sixteen stable methadone maintenance treatment participants (non-holders, n=8) were randomly allocated to continue methadone for 3 months or switch to LAAM for 3 months, and then crossed over to the alternative drug for 3 months. At steady state, there were two testing sessions (24 h for methadone and 48 h for LAAM), during which opioid withdrawal severity, respiration rate and pupil diameter were measured 1011 times and venous blood was collected 1315 times. Ten age- and gender-matched controls underwent one 48-h test session. Areas under the withdrawal severity score versus time curve (AUC047 hours for LAAM and controls; AUC024 * 2 for methadone) were similar in holders on methadone and LAAM (P=0.62), but were greater in non-holders when they were taking methadone than LAAM (P<0.001). Respiratory depression and pupillary constriction were similar for LAAM and methadone. In comparison to (R)-methadone, plasma nor- and dinor-LAAM concentrations fluctuated little over the dosing interval. LAAM converted methadone non-holders into LAAM holders. LAAM may therefore be useful in selected MMT non-holders and improve retention in opioid treatment programs. (Review's abstract.)
Affiliation :
Dept. Clinic. Experim. Pharmacol., Univ. Adelaide, Adelaide 5005 ; jason.whiteadelaide.edu.au
Australie. Australia.
Australie. Australia.