Mysels David J, Vosburg Suzanne K, Benga Ileana, Levin Frances R, Sullivan Maria A
Division of Addiction Psychiatry, Columbia University College of Physicians and Surgeons, New York, New York, USA.
J Opioid Manag. 2011 Jan-Feb;7(1):47-53. doi: 10.5055/jom.2011.0048.
micro-Opiate receptor agonism has been associated with weight gain, whereas micro-antagonists have been associated with weight neutrality, or even weight loss.
This study examined the course of weight changes in opiate-dependent patients over the first 6 months of treatment in methadone (agonist) versus naltrexone (antagonist) maintenance.
A retrospective chart review was conducted on 36 opiate-dependent patients maintained on methadone (n=16) or naltrexone (n=20). OUTCOME MEASURES AND ANALYSES: The primary outcome measure was change in body weight from baseline to 3 months and 6 months into treatment. Analysis of variance was used to compare mean weights between the methadone- and naltrexone-maintained patients. Secondarily, mean percent weight changes from baseline to 3 months and from baseline to 6 months into treatment were compared using Student's t-test.
There was no difference between weight at baseline, 3 months, or 6 months into treatment between the two treatment groups. Furthermore, there was also no difference between the two groups regarding percent weight change from baseline to 3 months or baseline to 6 months. At 3 months, n=16 methadone patients had a mean weight increase of 1.86 percent (standard deviation [SD] = 7.22 percent) when compared with n=20 Behavioral Naltrexone Therapy (BNT) patients with an increase of 4.63 percent (SD = 6.49 percent). At 6 months, n=16 methadone patients had a mean weight increase relative to baseline of 3.67 percent (SD = 9.52percent) when compared with n=20 BNT patients, who demonstrated a mean increase of 6.69 percent (SD = 7.56 percent). No association was found between baseline weight, defined as "low" or "high" relative to group medians, and percent gain within and between treatment groups.
This study did not detect a statistically different course of weight gain between methadone and naltrexone maintenance treatment for opiate-dependent patients.
μ-阿片受体激动剂与体重增加有关，而μ-拮抗剂与体重保持中性甚至体重减轻有关。
本研究调查了阿片类药物依赖患者在美沙酮（激动剂）与纳曲酮（拮抗剂）维持治疗的前6个月内体重变化的过程。
对36例接受美沙酮维持治疗（n = 16）或纳曲酮维持治疗（n = 20）的阿片类药物依赖患者进行回顾性病历审查。结果测量与分析：主要结果测量指标是从基线到治疗3个月和6个月时体重的变化。采用方差分析比较美沙酮维持治疗组和纳曲酮维持治疗组患者的平均体重。其次，使用学生t检验比较从基线到治疗3个月以及从基线到治疗6个月时体重变化的平均百分比。
两个治疗组在基线、治疗3个月或6个月时的体重没有差异。此外，两组从基线到治疗3个月或从基线到治疗6个月的体重变化百分比也没有差异。在3个月时，16例美沙酮维持治疗患者的平均体重增加了1.86%（标准差[SD]=7.22%），而20例接受行为纳曲酮治疗（BNT）的患者平均体重增加了4.63%（SD = 6.49%）。在6个月时，16例美沙酮维持治疗患者相对于基线的平均体重增加了3.67%（SD = 9.52%），而20例接受BNT治疗患者的平均体重增加了6.69%（SD = 7.56%）。未发现相对于组中位数定义为“低”或“高”的基线体重与治疗组内及治疗组间体重增加百分比之间存在关联。
本研究未发现阿片类药物依赖患者在美沙酮和纳曲酮维持治疗之间体重增加的过程存在统计学差异。
