Assessment of treatment efficacy for codeine-containing cough syrup dependence using single-photon emission computed...

Codeine-containing cough syrup (CCS) misuse has become a growing global concern, particularly among young people, due to its potential for dependence. This study aimed to evaluate the efficacy of a comprehensive treatment approach for patients with dependence on CCS and to assess treatment outcomes through single-photon emission computed tomography (SPECT).

This study included 29 patients with CCS dependence and 31 matched controls. SPECT imaging was performed using the radiopharmaceutical agent ^99mTc-TRODAT-1. Patients with CCS dependence underwent comprehensive treatment, and SPECT examinations were conducted both before and after the intervention. Dopamine transporter (DAT) availability in the striatum was measured, and the volume (V), weight (W), and uptake ratio of corpus striatum/the whole brain (Ra) of ^99mTc-TRODAT-1 in the striatum relative to the whole brain were calculated using mathematical models.

Patients with CCS dependence exhibited significantly reduced DAT availability in the striatum, as well as decreased V (21.12±5.65 cm³), W (22.98±7.62 g), and Ra [(4.16±1.12)%] values, compared to the control group before treatment. Following treatment, clinical symptoms improved to varying degrees. DAT availability, along with V (30.90±9.14 cm³), W (32.44±9.60 g), and Ra [(7.06±1.84)%] values, increased significantly compared to pre-treatment levels (P<0.01) but remained lower than those observed in the control group.

The comprehensive treatment approach demonstrated effectiveness in improving clinical and imaging outcomes in patients with CCS dependence. However, complete recovery of striatal DAT availability and related parameters was not achieved for these patients. TRODAT SPECT brain imaging was proven to be a useful imaging modality for assessment of the effectiveness of treatment methods in CCS dependence.