在阿片类药物依赖的治疗中中度或高剂量的甲:一个随机试验
E C Strain1, G E Bigelow, I A Liebson
1Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA. ecsgss@aol.com
JAMA
|March 23, 1999
概括
与中等剂量相比,在阿片类药物依赖的患者中,高剂量甲化治疗显著减少了非法阿片类药物的使用. 这两种剂量都有助于排毒和维持,但高剂量的甲在减少非法阿片类药物使用方面表现出更大的有效性.
科学领域:
- 成 药物 药物 药物 药物
- 药理学 药理学是指药理学的学科.
- 临床试验 临床试验
背景情况:
- 甲化是治疗阿片类药物依赖的主要药物治疗方法.
- 越来越多的人对扩大超越专业诊所的甲治疗机会感兴趣.
- 缺乏对更高甲剂量进行调查的受控试验.
研究的目的:
- 为了比较中剂量与高剂量甲在治疗阿片类药物依赖方面的临床有效性.
- 评估不同甲剂量对非法阿片类药物使用和治疗保留的影响.
主要方法:
- 从1992年6月到1995年10月,进行了一项为期40周的随机双盲临床试验.
- 在门诊药物滥用研究诊所的192名符合条件的患者每天接受口服甲化 (40-50毫克或80-100毫克) 和咨询.
- 主要结局指标包括阿片类药物阳性尿液分析结果和治疗持续时间.
主要成果:
- 接受高剂量甲 (80-100毫克) 的患者在30周内,与中剂量组相比,阿片类药物阳性尿样的比率显著降低 (53.0%对61.9%,P = .047).
- 在甲戒断期间,非法阿片类药物使用的减少仍然存在.
- 两组之间没有观察到治疗持续时间的显著差异 (平均持续时间为159天与157天).
- 在高剂量组中,检毒完成率更高 (33%对20%).
结论:
- 中等剂量和高剂量的甲化有效地减少了维持和排毒期间的非法阿片类药物使用.
- 高剂量甲治疗在减少阿片类药物依赖患者非法阿片类药物使用方面表现出更高的疗效.
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