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|Title:||Methadone Dose Adjustments, Plasma R-Methadone Levels and Therapeutic Outcome of Heroin Users: A Randomized Clinical Trial|
|Authors:||Mannaioni, Guido;Lanzi, Cecilia;Lotti, Michela;Galli, Valentina;Totti, Arianna;Pacileo, Ilaria;Sili, Maria;Pracucci, Chiara;Dilaghi, Arianna;Bertieri, Lara;Quaranta, Mariarita;Orsini, Francesco;Occupati, Brunella;Michahelles, Assia;Ciuti, Riccardo;Bianchini, Elisa;Fabbro, Giancarlo;Biggeri, Annibale;Masini, Emanuela;Moroni, Flavio|
|Keywords:||Heroin use disorders;Methadone dose;Methadone maintenance treatment;R-methadone plasma levels;Retention in treatment;10.1159/000485029|
|Abstract:||© 2018 S. Karger AG, Basel Aims: We aimed to improve the retention in treatment and therapeutic outcome of methadone maintenance treatment (MMT) patients by adjusting the oral methadone dose in order to reach a “target” plasma R-methadone level (80–250 ng/mL). Methods: A multicenter randomized controlled trial was organized. Results: The intention-to-treat statistical analysis showed that repeated dose adjustments performed in order to obtain therapeutic plasma R-methadone levels did not improve retention in treatment of heroin-dependent patients. However, patients having plasma methadone levels in the “target range” at the beginning of the study had a better retention in treatment than controls. Furthermore, patients succeeding in keeping plasma R-methadone target levels (per protocol analysis) remained in treatment and improved their social scores better than controls. Conclusion: Although the primary endpoint of this study was not demonstrated, a post hoc and a pe r protocol analysis suggested that patients in MMT with plasma R-methadone concentrations in the target range have a better therapeutic outcome than controls.|
|More Information:||START PAGE : 9 END PAGES : 18|
|Appears in Collections:||European Addiction Research|
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