Eiden Céline, Leglise Yves, Clarivet Béatrice, Blayac Jean-Pierre, Peyrière Hélène
Service de Pharmacologie médicale et Toxicologie, Centre d'Addictovigilance, Hôpital Lapeyronie, CHU Montpellier, UM1, Montpellier, France.
Therapie. 2012 May-Jun;67(3):223-30. doi: 10.2515/therapie/2012025. Epub 2012 Aug 9.
Recent studies show that high-dose methadone (>100 mg/d) allow a better control of the consumptions of illicit opiates by treated patients.
The aim of this retrospective study was to analyze data of patients requiring high-dose methadone (>100 mg/d) as well as associated factors.
We retrospectively reviewed charts of treated patients with high-dose methadone followed in the maintenance methadone treatment center between 01/01/07 and 01/07/10. The following variables (medical history, psychiatric comorbidities, associated drugs, and polyaddictions), were assessed with high-dose methadone, using an univariate and then a multavariate analysis. The threshold value of 130 mg/day (median of maximal daily dose) was used to perform analysis.
During the study period, 78 patients, mainly men (75.6%), with a median age of 34 years [22-57] were included. The both groups with posology of methadone ≤ 130 mg/d (n=44) versus posology of methadone >130 mg/d (n=34) were close in term of demographic characteristics, consumption of drugs and associated treatments. Plasma methadone concentrations were higher in patients with the daily doses of methadone superior than 130 mg/d (NS), as well as the methadone metabolite (EDDP, p=0.048). Among studied factors, the presence of psychiatric comorbidities was significantly associated with high-dose methadone (threshold 130 mg/d) [OR 4,6 IC 95% (1.412;14.925)]. Seven patients presented with complications related to methadone: cardiac disorder (3), libido troubles (3) and hypofertility (1).
Patients requiring high-dose methadone are polydrug addicts. In our study, patients with psychiatric comorbidities needed daily dose of methadone significantly more raised.
近期研究表明，高剂量美沙酮（>100毫克/天）能更好地控制接受治疗患者的非法阿片类药物使用量。
这项回顾性研究的目的是分析需要高剂量美沙酮（>100毫克/天）的患者数据以及相关因素。
我们回顾性分析了2007年1月1日至2010年7月1日在美沙酮维持治疗中心接受高剂量美沙酮治疗患者的病历。使用单变量分析，然后进行多变量分析，评估以下变量（病史、精神疾病共病、相关药物和多种成瘾情况）与高剂量美沙酮的关系。使用130毫克/天（最大日剂量中位数）的阈值进行分析。
在研究期间，纳入了78例患者，主要为男性（75.6%），中位年龄为34岁[22 - 57岁]。美沙酮剂量≤130毫克/天的组（n = 44）与美沙酮剂量>130毫克/天的组（n = 34）在人口统计学特征、药物使用和相关治疗方面相近。美沙酮日剂量高于130毫克/天的患者血浆美沙酮浓度较高（无统计学差异），美沙酮代谢物（EDDP，p = 0.048）也是如此。在研究的因素中，精神疾病共病与高剂量美沙酮（阈值130毫克/天）显著相关[比值比4.6，95%置信区间（1.412；14.925）]。7例患者出现与美沙酮相关的并发症：心脏疾病（3例）、性欲问题（3例）和生育能力低下（1例）。
需要高剂量美沙酮的患者是多药成瘾者。在我们的研究中，有精神疾病共病的患者美沙酮日剂量明显更高。
