Doctor of Medicine Program, Penn State College of Medicine, Hershey, Pennsylvania, USA.
Departments of Anesthesiology and Perioperative Medicine and Pharmacology, Penn State College of Medicine, Hershey, Pennsylvania, USA.
Subst Use Misuse. 2023;58(13):1751-1760. doi: 10.1080/10826084.2023.2247071. Epub 2023 Aug 16.
To investigate FDA-approved drugs prescribed for unrelated diseases or conditions that promote remission in subjects diagnosed with opioid use disorder (OUD).
This was a retrospective observational study utilizing the TriNetX electronic medical record data. Subjects between 18 and 65 years old were included in this study. First, a drug screen was employed to identify medications used for chronic illness that are associated with OUD remission. Based on Fisher's exact test for significance, 28 of 101 medications were selected for further analysis. Positive (buprenorphine/methadone) and negative controls (benazepril) were included in the analysis. Medications were analyzed in the absence and presence of buprenorphine or methadone, two medications used to treat OUD, to identify the likelihood of OUD remission up to one year following the index event.
We identify 8 medications (prazosin, propranolol, lithium carbonate, olanzapine, quetiapine, bupropion, citalopram, and escitalopram) that may be useful for increasing remission in OUD in the absence of buprenorphine or methadone. Additionally, our results identify psychiatric medications that when taken alongside buprenorphine and methadone improve remission rates.
These results provide medication options that may be useful in treating OUD as well as integrated therapies to treat comorbid mental illness.
调查美国食品和药物管理局 (FDA) 批准用于治疗与阿片类药物使用障碍 (OUD) 无关的疾病或病症的药物，以促进这些患者的缓解。
这是一项回顾性观察性研究，使用了 TriNetX 电子病历数据。本研究纳入了年龄在 18 至 65 岁之间的受试者。首先，进行药物筛选以确定用于治疗与 OUD 缓解相关的慢性疾病的药物。基于 Fisher 确切检验的显著性，从 101 种药物中选择了 28 种进行进一步分析。阳性对照（丁丙诺啡/美沙酮）和阴性对照（贝那普利）纳入了分析。分析了在没有和存在丁丙诺啡或美沙酮（两种用于治疗 OUD 的药物）的情况下的药物，以确定在索引事件发生后一年的时间内 OUD 缓解的可能性。
我们确定了 8 种药物（哌唑嗪、普萘洛尔、碳酸锂、奥氮平、喹硫平、安非他酮、西酞普兰和艾司西酞普兰），在没有丁丙诺啡或美沙酮的情况下，这些药物可能对增加 OUD 的缓解有用。此外，我们的结果还确定了一些精神科药物，当与丁丙诺啡和美沙酮一起使用时，可以提高缓解率。
这些结果提供了一些可能对治疗 OUD 有用的药物选择，以及治疗共病精神疾病的综合治疗方法。
