Treatment of polydrug-using opiate dependents during withdrawal: towards a standardisation of treatment

<p>Abstract</p> <p>Background</p> <p>The growing tendency among opioid addicts to misuse multiple other drugs should lead clinicians and researchers to search for new pharmacological strategies in order to prevent life-threatening complications and minimize withdrawal s...

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Main Authors: Vederhus John-Kåre, Isaksen Åse, Lølandsmo Terje, Kristensen Øistein, Clausen Thomas
Format: Article
Language:English
Published: BMC 2006-11-01
Series:BMC Psychiatry
Online Access:http://www.biomedcentral.com/1471-244X/6/54
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spelling doaj-c68e3a74edfa4629ab744b66a147d4f72020-11-24T20:47:26ZengBMCBMC Psychiatry1471-244X2006-11-01615410.1186/1471-244X-6-54Treatment of polydrug-using opiate dependents during withdrawal: towards a standardisation of treatmentVederhus John-KåreIsaksen ÅseLølandsmo TerjeKristensen ØisteinClausen Thomas<p>Abstract</p> <p>Background</p> <p>The growing tendency among opioid addicts to misuse multiple other drugs should lead clinicians and researchers to search for new pharmacological strategies in order to prevent life-threatening complications and minimize withdrawal symptoms during polydrug detoxification.</p> <p>Methods</p> <p>A non-randomised, open-label in-patient detoxification study was used to compare the short-time efficacy of a standardised regimen comprising 6 days Buprenorphine and 10 days Valproate (BPN/VPA) (n = 12) to a control group (n = 50) who took a 10-day traditional Clonidine/Carbamazepine (CLN/CBZ) regimen. Sixty-two dependent subjects admitted to a detoxification unit were included, all dependent on at least opioids and benzodiazepines. Other dependencies were not excluded.</p> <p>Results</p> <p>In the BPN/VPA group, 8 out of 12 patients (67%) completed treatment compared with 25 of 50 patients (50%) in the CLN/CBZ group; this difference between the groups was non-significant (p = 0.15). Withdrawal symptoms were reduced in both groups, but only the BPN/VPA group achieved a reduction in withdrawal symptoms from day one. The difference between the two groups was significantly in favour of the BPN/VPA group for days 2 (p < 0.001), 3 (p < 0.05), 4 (p < 0.001), 5 (p < 0.01), 7 (p < 0.01) and 8 (p < 0.05). The BPN/VPA combination did not affect blood pressure, pulse or liver function, and the total burden of side-effects was experienced as modest. There appeared to be no pharmacological interactions of clinical concern, based on measurement of Buprenorphine and Valproate serum levels. Both the patients and the staff were satisfied with the standardised treatment combination.</p> <p>Conclusion</p> <p>Overall, the combination of Buprenorphine and Valproate seems to be a safe and promising method for treating multiple drug withdrawal symptoms. The results of this study suggest that the BPN/VPA combination is potentially a better detoxification treatment for polydrug withdrawal than the traditional treatment with Clonidine and Carbamazepine. However, a randomised, double-blind study with a larger sample size to confirm our results is recommended.</p> <p>Trial registration</p> <p>Clinical Trials.gov: NCT00367874</p> http://www.biomedcentral.com/1471-244X/6/54
collection DOAJ
language English
format Article
sources DOAJ
author Vederhus John-Kåre
Isaksen Åse
Lølandsmo Terje
Kristensen Øistein
Clausen Thomas
spellingShingle Vederhus John-Kåre
Isaksen Åse
Lølandsmo Terje
Kristensen Øistein
Clausen Thomas
Treatment of polydrug-using opiate dependents during withdrawal: towards a standardisation of treatment
BMC Psychiatry
author_facet Vederhus John-Kåre
Isaksen Åse
Lølandsmo Terje
Kristensen Øistein
Clausen Thomas
author_sort Vederhus John-Kåre
title Treatment of polydrug-using opiate dependents during withdrawal: towards a standardisation of treatment
title_short Treatment of polydrug-using opiate dependents during withdrawal: towards a standardisation of treatment
title_full Treatment of polydrug-using opiate dependents during withdrawal: towards a standardisation of treatment
title_fullStr Treatment of polydrug-using opiate dependents during withdrawal: towards a standardisation of treatment
title_full_unstemmed Treatment of polydrug-using opiate dependents during withdrawal: towards a standardisation of treatment
title_sort treatment of polydrug-using opiate dependents during withdrawal: towards a standardisation of treatment
publisher BMC
series BMC Psychiatry
issn 1471-244X
publishDate 2006-11-01
description <p>Abstract</p> <p>Background</p> <p>The growing tendency among opioid addicts to misuse multiple other drugs should lead clinicians and researchers to search for new pharmacological strategies in order to prevent life-threatening complications and minimize withdrawal symptoms during polydrug detoxification.</p> <p>Methods</p> <p>A non-randomised, open-label in-patient detoxification study was used to compare the short-time efficacy of a standardised regimen comprising 6 days Buprenorphine and 10 days Valproate (BPN/VPA) (n = 12) to a control group (n = 50) who took a 10-day traditional Clonidine/Carbamazepine (CLN/CBZ) regimen. Sixty-two dependent subjects admitted to a detoxification unit were included, all dependent on at least opioids and benzodiazepines. Other dependencies were not excluded.</p> <p>Results</p> <p>In the BPN/VPA group, 8 out of 12 patients (67%) completed treatment compared with 25 of 50 patients (50%) in the CLN/CBZ group; this difference between the groups was non-significant (p = 0.15). Withdrawal symptoms were reduced in both groups, but only the BPN/VPA group achieved a reduction in withdrawal symptoms from day one. The difference between the two groups was significantly in favour of the BPN/VPA group for days 2 (p < 0.001), 3 (p < 0.05), 4 (p < 0.001), 5 (p < 0.01), 7 (p < 0.01) and 8 (p < 0.05). The BPN/VPA combination did not affect blood pressure, pulse or liver function, and the total burden of side-effects was experienced as modest. There appeared to be no pharmacological interactions of clinical concern, based on measurement of Buprenorphine and Valproate serum levels. Both the patients and the staff were satisfied with the standardised treatment combination.</p> <p>Conclusion</p> <p>Overall, the combination of Buprenorphine and Valproate seems to be a safe and promising method for treating multiple drug withdrawal symptoms. The results of this study suggest that the BPN/VPA combination is potentially a better detoxification treatment for polydrug withdrawal than the traditional treatment with Clonidine and Carbamazepine. However, a randomised, double-blind study with a larger sample size to confirm our results is recommended.</p> <p>Trial registration</p> <p>Clinical Trials.gov: NCT00367874</p>
url http://www.biomedcentral.com/1471-244X/6/54
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