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Limits to buprenorphine dosing: a comparison between quintuple and sextuple the maintenance dose every 5 days
A Gross1, E A Jacobs, N M Petry
1Substance Abuse Treatment Center, University of Vermont, 1 South Prospect Street, Burlington, VT 05401, USA. agross@zoo.uvm.edu
Drug and Alcohol Dependence
|July 27, 2001
Summary
Quintuple and sextuple buprenorphine dosing every 5 days did not significantly differ in reducing opioid withdrawal symptoms beyond 96 hours. Higher doses did not provide extended relief for opioid dependence treatment.
Area of Science:
- Pharmacology
- Addiction Medicine
- Clinical Research
Background:
- Opioid dependence is a significant public health issue requiring effective long-term management strategies.
- Buprenorphine is a widely used medication for opioid use disorder, but optimal dosing intervals for sustained withdrawal symptom abatement require further investigation.
Purpose of the Study:
- To compare the efficacy of quintuple versus sextuple buprenorphine doses in alleviating opioid withdrawal symptoms over 120 hours.
- To determine if increased buprenorphine dosing frequency impacts the duration of withdrawal symptom control in outpatients.
Main Methods:
- A double-blind, placebo-controlled, cross-over study involving 14 opioid-dependent outpatients.
- Subjects received daily sublingual buprenorphine maintenance doses (4 mg/70 kg or 8 mg/70 kg).
- Following stabilization, subjects received either quintuple (5x maintenance) or sextuple (6x maintenance) doses every 120 hours, with daily assessments of opioid agonist and withdrawal effects.
Main Results:
- Subjective withdrawal ratings were significantly elevated above baseline beyond 96 hours post-dosing in both the quintuple and sextuple dosing regimens.
- No statistically significant difference was observed in the subjective ratings of withdrawal symptoms between the quintuple and sextuple buprenorphine dosing regimens.
- Increased buprenorphine dosing did not extend the period of withdrawal symptom abatement beyond 96 hours.
Conclusions:
- Administering sextuple buprenorphine doses every 5 days does not provide sustained opioid withdrawal symptom relief beyond 96 hours.
- Current dosing strategies may require further optimization to achieve prolonged efficacy in managing opioid withdrawal symptoms in outpatient settings.