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Comparative study of the effectiveness of slow-release morphine and methadone for opioid maintenance therapy
(Etude comparative de l'efficacité de la morphine à doses filées et de la méthadone dans le traitement de maintenance de la dépendance aux opioïdes.)
Auteur(s) :
H. EDER ;
R. JAGSCH ;
D. KRAIGHER ;
A. PRIMORAC ;
N. EBNER ;
G. FISCHER
Article en page(s) :
1101-1109
Refs biblio. :
43
Domaine :
Autres substances / Other substances ; Drogues illicites / Illicit drugs
Langue(s) :
Anglais
Thésaurus mots-clés
TRAITEMENT DE MAINTENANCE
;
METHADONE
;
MORPHINE
;
EFFICACITE
;
COMPARAISON
;
ETUDE RANDOMISEE
Thésaurus géographique
AUTRICHE
Note générale :
Addiction, 2005, 100, (8), 1101-1109
Résumé :
FRANÇAIS :
64 patients recevant soit une dose moyenne de 85 mg de méthadone soit une dose moyenne de 680 mg de morphine sont évalués sur les critères de rétention en traitement, de consommation de drogues illicites (tests urinaires), de symptôme de sevrage et de bien-être général. Entre les deux groupes, aucune différence n'est observée par rapport à la rétention en traitement ou la consommation de drogues illicites. Cependant, les patients sous morphine présentent moins de symptômes de dépression ou d'anxiété et rapportent plus de gêne physique. La conclusion de l'étude est que des doses filées de morphine sont aussi efficaces que la méthadone avec une tolérance et une sécurité similaires.
ENGLISH:
Aims Slow-release morphine may represent a much-needed new pharmacological treatment for opioid dependence. Design In a 14-week randomized, double-blind, double-dummy, cross-over study oral slow-release morphine was compared with methadone as a treatment for opioid dependency. During two study periods, each consisting of a 1-week titration and a 6-week fixed-dose treatment phase, medication was administered daily under supervised conditions. Setting The study was carried out at the Addiction Clinic, Department of Psychiatry, Medical University Vienna. Participants Sixty-four subjects (56 males, eight females) with opioid dependence participated in the trial. Measurements Efficacy was evaluated on the basis of retention, use of illicit substances based on urinalysis, extent of drug cravings, withdrawal symptoms and general wellbeing. Safety was assessed on the basis of adverse events and clinical and physical examination. Demographic and baseline characteristics were assessed using the European Addiction Severity Index. Findings Fifty-five patients (86%) completed the study, with a mean methadone dose of 85 mg and a mean slow-release morphine dose of 680 mg. No significant differences in retention or use of illicit substances (opioids, benzodiazepines, cocaine) were observed, irrespective of treatment group or medication. However, patients receiving slow-release morphine had significantly lower depression (P
64 patients recevant soit une dose moyenne de 85 mg de méthadone soit une dose moyenne de 680 mg de morphine sont évalués sur les critères de rétention en traitement, de consommation de drogues illicites (tests urinaires), de symptôme de sevrage et de bien-être général. Entre les deux groupes, aucune différence n'est observée par rapport à la rétention en traitement ou la consommation de drogues illicites. Cependant, les patients sous morphine présentent moins de symptômes de dépression ou d'anxiété et rapportent plus de gêne physique. La conclusion de l'étude est que des doses filées de morphine sont aussi efficaces que la méthadone avec une tolérance et une sécurité similaires.
ENGLISH:
Aims Slow-release morphine may represent a much-needed new pharmacological treatment for opioid dependence. Design In a 14-week randomized, double-blind, double-dummy, cross-over study oral slow-release morphine was compared with methadone as a treatment for opioid dependency. During two study periods, each consisting of a 1-week titration and a 6-week fixed-dose treatment phase, medication was administered daily under supervised conditions. Setting The study was carried out at the Addiction Clinic, Department of Psychiatry, Medical University Vienna. Participants Sixty-four subjects (56 males, eight females) with opioid dependence participated in the trial. Measurements Efficacy was evaluated on the basis of retention, use of illicit substances based on urinalysis, extent of drug cravings, withdrawal symptoms and general wellbeing. Safety was assessed on the basis of adverse events and clinical and physical examination. Demographic and baseline characteristics were assessed using the European Addiction Severity Index. Findings Fifty-five patients (86%) completed the study, with a mean methadone dose of 85 mg and a mean slow-release morphine dose of 680 mg. No significant differences in retention or use of illicit substances (opioids, benzodiazepines, cocaine) were observed, irrespective of treatment group or medication. However, patients receiving slow-release morphine had significantly lower depression (P
Affiliation :
Addiction Clinic, Department of Psychiatry, Medical University Vienna, Vienna, Austria
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