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经颅直流电刺激对美沙酮维持治疗的阿片类药物依赖患者复发、焦虑和抑郁的影响:一项试点研究。

The Effect of Transcranial Direct Current Stimulation on Relapse, Anxiety, and Depression in Patients With Opioid Dependence Under Methadone Maintenance Treatment: A Pilot Study.

作者信息

Sadeghi Bimorgh Mohammad, Omidi Abdollah, Ghoreishi Fatemeh Sadat, Rezaei Ardani Amir, Ghaderi Amir, Banafshe Hamid Reza

机构信息

Department of Addiction Studies, School of Medical, Kashan University of Medical Sciences, Kashan, Iran.

Department of Clinical Psychology, School of Medicine, Kashan University of Medical Science, Kashan, Iran.

出版信息

Front Pharmacol. 2020 Apr 3;11:401. doi: 10.3389/fphar.2020.00401. eCollection 2020.

Abstract

BACKGROUND AND OBJECTIVE

Patients under methadone maintenance therapy (MMT) are susceptible to several complications including mental disturbances and risk of relapse. The present study was designed to evaluate the effects of tDCS on relapse, depression, and anxiety of opioid-dependent patients under methadone maintenance treatment (MMT).

METHODS

It was a randomized-clinical trial that conducted among 27 male patients referred to the outpatient addiction clinic of Ibn-e-Sina psychiatric hospital in Mashhad from July 2018 to May 2019. Participants were allocated to two treatment groups including intervention and sham groups. The intervention group received seven sessions of tDCS, in the F3 (cathode) and F4 (anode) areas of the brain, each one lasts 20 min, in two consecutive weeks. Depression, anxiety, and stress scale-21 (DASS-21) were measured before, during, and after the intervention in patients under MMT. Relapse on the morphine, cannabis, and methamphetamine was screened by urine dipstick tests of morphine, cannabis, and methamphetamine.

RESULTS

Depression, anxiety, and stress of participants were significantly reduced in the intervention group compared with the control after the seventh session of tDCS (P < 0.001, P=0.01, and P=0.01, respectively). In addition, the relapse rate showed no significant changes between the two groups (P=0.33).

CONCLUSION

Overall, our study demonstrated that depression, anxiety, and stress of participants were significantly reduced after the seventh session of tDCS, but did not affect on the relapse rate. Therefore, it can be applied as a safe and effective technique to relieve mental disorder among receiving MMT.

CLINICAL TRIAL REGISTRATION

http://www.irct.ir, identifier IRCT20180604039979N1.

摘要

背景与目的

接受美沙酮维持治疗(MMT)的患者易出现多种并发症,包括精神障碍和复发风险。本研究旨在评估经颅直流电刺激(tDCS)对接受美沙酮维持治疗(MMT)的阿片类药物依赖患者的复发、抑郁和焦虑的影响。

方法

这是一项随机临床试验,于2018年7月至2019年5月在马什哈德伊本·西那精神病医院门诊成瘾诊所的27名男性患者中进行。参与者被分配到两个治疗组,即干预组和假刺激组。干预组在大脑的F3(阴极)和F4(阳极)区域接受七次tDCS治疗,每次持续20分钟,连续两周进行。在MMT患者干预前、干预期间和干预后测量抑郁、焦虑和压力量表-21(DASS-21)。通过吗啡、大麻和甲基苯丙胺的尿液试纸检测筛查吗啡、大麻和甲基苯丙胺的复发情况。

结果

与对照组相比,干预组在第七次tDCS治疗后,参与者的抑郁、焦虑和压力显著降低(分别为P < 0.001、P = 0.01和P = 0.01)。此外,两组之间的复发率没有显著变化(P = 0.33)。

结论

总体而言,我们的研究表明,在第七次tDCS治疗后,参与者的抑郁、焦虑和压力显著降低,但对复发率没有影响。因此,它可以作为一种安全有效的技术用于缓解接受MMT患者的精神障碍。

临床试验注册

http://www.irct.ir,标识符IRCT20180604039979N1。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ebe/7145941/0b1b54c9f8b6/fphar-11-00401-g005.jpg

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