Schottenfeld R S, Pakes J R, Kosten T R
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
J Nerv Ment Dis. 1998 Jan;186(1):35-43. doi: 10.1097/00005053-199801000-00006.
This study a) compared the effects of buprenorphine versus methadone maintenance on benzodiazepine and alcohol use and b) evaluated the prognostic significance of gender and psychopathology and their interaction with maintenance treatment. Eighty male and 36 female patients were randomly assigned to daily sublingual buprenorphine (4 or 12 mg) or oral methadone (20 or 65 mg). Maintenance medication was not associated with significant differences in alcohol or benzodiazepine use. Rates of abstinence from illicit opioids were significantly higher for females, within the buprenorphine 4-mg group, females also had significantly better retention, lower rates of opioid-positive urine samples, and higher rates of abstinence from illicit opioids. Lifetime sedative dependence was associated with significantly better retention, decreased rates of cocaine-positive urine samples, and increased rates of cocaine abstinence; among buprenorphine- but not methadone-maintained patients, it was also associated with increased rates of abstinence from illicit opioids.
a）比较了丁丙诺啡与美沙酮维持治疗对苯二氮䓬类药物和酒精使用的影响；b）评估了性别和精神病理学及其与维持治疗的相互作用的预后意义。80名男性和36名女性患者被随机分配至每日舌下含服丁丙诺啡（4毫克或12毫克）或口服美沙酮（20毫克或65毫克）治疗组。维持治疗药物与酒精或苯二氮䓬类药物使用的显著差异无关。女性非法阿片类药物戒断率显著更高，在丁丙诺啡4毫克组中，女性的留存率也显著更好，阿片类药物阳性尿样率更低，非法阿片类药物戒断率更高。终生镇静剂依赖与显著更好的留存率、可卡因阳性尿样率降低以及可卡因戒断率增加相关；在丁丙诺啡维持治疗而非美沙酮维持治疗的患者中，它还与非法阿片类药物戒断率增加相关。
