Effects of buprenorphine and methadone in methadone-maintained subjects

Effects of buprenorphine and methadone in methadone-maintained subjects 213 119 119 3 3 S. L. Walsh H. L. June K. J. Schuh K. L. Preston G. E. Bigelow M. L. Stitzer Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Science Johns Hopkins University School of Medicine 21224 Baltimore MD USA Departments of Psychology and Medical Neurobiology Indiana University-Purdue University Indianapolis Indiana USA Clinical Trials Branch, Addiction Research Center National Institute on Drug Abuse Baltimore Maryland USA Abstract Buprenorphine, a partial mu opioid agonist, is an experimental medication under development for the treatment of opioid dependence as an alternative to methadone maintenance. The present study examined the relationship between level of opioid physical dependence and response to buprenorphine administration as part of a program to develop procedures for transferring patients from methadone to buprenorphine treatment. This laboratory study characterized the agonist and antagonist effects of acute doses of buprenorphine and methadone in subjects maintained on either 30 ( n =7) or 60 ( n =6) mg/day oral methadone. Test doses of placebo (sl. and PO), methadone (15, 30, and 60 mg PO) and buprenorphine (2, 4, and 8 mg sl.) were administered to volunteers residing on a closed residential unit. Subjective, physiological, observer-rated, and cognitive/psychomotor measures were collected for 6.5 h after test doses. Test doses of methadone, but not buprenorphine, constricted pupils and produced dose-related increases on subjective report measures reflecting opioid agonist drug effects. Agonist effects of methadone were more prominent in the 30 mg than in the 60 mg methadone maintenance condition. Buprenorphine, but not methadone, precipitated opioid withdrawal signs and symptoms that were more prominent in the 60 mg than in the 30 mg methadone maintenance condition. These findings suggest that abrupt transition from methadone to buprenorphine may produce patient discomfort that is positively related to both methadone maintenance dose and buprenorphine transition dose. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Psychopharmacology Springer Journals

Effects of buprenorphine and methadone in methadone-maintained subjects

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Publisher
Springer Journals
Copyright
Copyright © 1995 by Springer-Verlag
Subject
Biomedicine; Pharmacology/Toxicology; Psychiatry
ISSN
0033-3158
eISSN
1432-2072
DOI
10.1007/BF02246290
Publisher site
See Article on Publisher Site

Abstract

213 119 119 3 3 S. L. Walsh H. L. June K. J. Schuh K. L. Preston G. E. Bigelow M. L. Stitzer Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Science Johns Hopkins University School of Medicine 21224 Baltimore MD USA Departments of Psychology and Medical Neurobiology Indiana University-Purdue University Indianapolis Indiana USA Clinical Trials Branch, Addiction Research Center National Institute on Drug Abuse Baltimore Maryland USA Abstract Buprenorphine, a partial mu opioid agonist, is an experimental medication under development for the treatment of opioid dependence as an alternative to methadone maintenance. The present study examined the relationship between level of opioid physical dependence and response to buprenorphine administration as part of a program to develop procedures for transferring patients from methadone to buprenorphine treatment. This laboratory study characterized the agonist and antagonist effects of acute doses of buprenorphine and methadone in subjects maintained on either 30 ( n =7) or 60 ( n =6) mg/day oral methadone. Test doses of placebo (sl. and PO), methadone (15, 30, and 60 mg PO) and buprenorphine (2, 4, and 8 mg sl.) were administered to volunteers residing on a closed residential unit. Subjective, physiological, observer-rated, and cognitive/psychomotor measures were collected for 6.5 h after test doses. Test doses of methadone, but not buprenorphine, constricted pupils and produced dose-related increases on subjective report measures reflecting opioid agonist drug effects. Agonist effects of methadone were more prominent in the 30 mg than in the 60 mg methadone maintenance condition. Buprenorphine, but not methadone, precipitated opioid withdrawal signs and symptoms that were more prominent in the 60 mg than in the 30 mg methadone maintenance condition. These findings suggest that abrupt transition from methadone to buprenorphine may produce patient discomfort that is positively related to both methadone maintenance dose and buprenorphine transition dose.

Journal

PsychopharmacologySpringer Journals

Published: Jun 1, 1995

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