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美沙酮和丁丙诺啡作为成瘾治疗药物,根据其剂量不同,对炎症和渴望有不同影响。

Methadone and Buprenorphine as Medication for Addiction Treatment Diversely Affect Inflammation and Craving Depending on Their Doses.

作者信息

Leventelis Christonikos, Veskoukis Aristidis S, Rojas Gil Andrea Paola, Papadopoulos Panagiotis, Garderi Maria, Angeli Asimina, Kampitsi Antzouletta, Tsironi Maria

机构信息

Department of Nursing, University of Peloponnese, 22100 Tripoli, Greece.

Organization Against Drugs, 10433 Athens, Greece.

出版信息

Pharmacy (Basel). 2025 Mar 6;13(2):40. doi: 10.3390/pharmacy13020040.

Abstract

Buprenorphine and methadone are widely used as medication for addiction treatment (MAT) in patients with opioid use disorders. However, there is no compelling evidence of their impact on the immune-endocrine response. Therefore, the aim of this study was to examine the effects of the aforementioned medications on craving and on biomarkers of inflammation and cortisol, approaching the dose issue concurrently. Sixty-six patients (thirty-four under methadone and thirty-two under buprenorphine) who had just entered a MAT program and were stabilized with the suitable administered doses after a two-week process were divided into four groups based on medication dose (i.e., methadone high dose, buprenorphine high dose, methadone medium dose, and buprenorphine medium dose). The heroin craving questionnaire for craving assessment was completed, and the blood biomarkers were measured on Days 1 and 180. According to the results, high doses of both medications were accompanied by low levels of craving, cortisol, and inflammation on Day 1, and no alterations were observed on Day 180. On the contrary, medium doses reduced the tested psychosocial and biochemical parameters in terms of time, indicating a positive action for the patients. Concludingly, modifications in MAT doses are needed soon after the stabilization process to prevent inflammation and avoid relapse, thus helping opioid-addicted patients toward rehabilitation.

摘要

丁丙诺啡和美沙酮被广泛用作治疗阿片类药物使用障碍患者成瘾的药物(药物辅助治疗)。然而,没有令人信服的证据表明它们对免疫 - 内分泌反应有影响。因此,本研究的目的是研究上述药物对渴望以及炎症和皮质醇生物标志物的影响,同时探讨剂量问题。66名刚进入药物辅助治疗项目并在两周过程后以合适的给药剂量稳定下来的患者(34名接受美沙酮治疗,32名接受丁丙诺啡治疗)根据药物剂量分为四组(即美沙酮高剂量组、丁丙诺啡高剂量组、美沙酮中剂量组和丁丙诺啡中剂量组)。完成用于评估渴望的海洛因渴望问卷,并在第1天和第180天测量血液生物标志物。根据结果,两种药物的高剂量在第1天伴随着低水平的渴望、皮质醇和炎症,在第180天未观察到变化。相反,中剂量在时间方面降低了测试的心理社会和生化参数,表明对患者有积极作用。总之,在稳定过程后不久需要调整药物辅助治疗的剂量,以预防炎症并避免复发,从而帮助阿片类药物成瘾患者康复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9754/11932288/6b340e74d5f3/pharmacy-13-00040-g001.jpg

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