Memantine improves buprenorphine/naloxone treatment for opioid dependent young adults

被引:22
作者
Gonzalez, Gerardo [1 ,2 ,4 ]
DiGirolamo, Gregory [1 ,3 ]
Romero-Gonzalez, Mauricio [1 ,4 ]
Smelson, David [1 ]
Ziedonis, Douglas [1 ]
Kolodziej, Monika [1 ]
机构
[1] Univ Massachusetts, Sch Med, Div Addict Psychiat, Worcester, MA 01605 USA
[2] VA Cent Western Massachusetts Healthcare Syst, Leeds, MA USA
[3] Coll Holy Cross, Worcester, MA USA
[4] MAYU New England, New Haven, CT USA
关键词
Memantine; Buprenorphine; Opioid dependence; Early relapse; Young adults; RECEPTOR ANTAGONIST MEMANTINE; ADDICTION SEVERITY INDEX; REPLACEMENT THERAPY; PREFRONTAL CORTEX; OPIATE DEPENDENCE; RANDOMIZED-TRIAL; ANTISACCADE TASK; TOLERANCE; MORPHINE; COCAINE;
D O I
10.1016/j.drugalcdep.2015.09.020
中图分类号
R194 [卫生标准、卫生检查、医药管理];
学科分类号
摘要
Background: Opioid use disorders are considered a serious public health problem among young adults. Current treatment is limited to long-term opioid substitution therapy, with high relapse rates after discontinuation. This study evaluated the co-administration of memantine to brief buprenorphine pharmacotherapy as a treatment alternative. Methods: 13-week double-blind placebo-controlled trial evaluating 80 young adult opioid dependent participants treated with buprenorphine/naloxone 16-4 mg/day and randomized to memantine (15 mg or 30 mg) or placebo. Primary outcomes were a change in the weekly mean proportion of opioid use, and cumulative abstinence rates after rapid buprenorphine discontinuation on week 9. Results: Treatment retention was not significantly different between groups. The memantine 30 mg group was significantly less likely to relapse and to use opioids after buprenorphine discontinuation. Among participants abstinent on week 8, those in the memantine 30 mg group (81.9%) were significantly less likely to relapse after buprenorphine was discontinued compared to the placebo group (30%) (p < 0.025). Also, the memantine 30 mg group had significantly reduced opioid use (mean = 0, SEM +/- 0.00) compared to the placebo group (mean = 0.33, SEM 0.35; p < 0.004) during the last 2 weeks of study participation. Conclusions: Memantine 30 mg significantly improved short-term treatment with buprenorphine/naloxone for opioid dependent young adults by reducing relapse and opioid use after buprenorphine discontinuation. Combined short-term treatment with buprenorphine/naloxone may be an effective alternative treatment to long-term methadone or buprenorphine maintenance in young adults. Published by Elsevier Ireland Ltd.
引用
收藏
页码:243 / 253
页数:11
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