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首页> 外文期刊>Substance Abuse Treatment, Prevention, and Policy >Subjective symptoms and serum methadone concentrations: what should guide dose adjustments in methadone maintenance treatment? A naturalistic cohort study from Norway
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Subjective symptoms and serum methadone concentrations: what should guide dose adjustments in methadone maintenance treatment? A naturalistic cohort study from Norway

机译：主观症状和血清美沙酮浓度：引导剂量调整在美沙酮维持治疗中是什么？ 来自挪威的自然队列研究

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There is little evidence-based guidance on how to optimize methadone dosages among patients with opioid addiction undergoing methadone maintenance treatment (MMT). This study aims to investigate whether self-perceived opioid withdrawal symptoms, adverse effects, and self-reported substance use in patients on MMT are related to serum methadone concentrations and the role that these variables could play in clinical decisions on dose adjustments. This naturalistic prospective cohort study included clinical and laboratory measurements from 83 patients undergoing MMT in outpatient clinics in Bergen, Norway, from May 2017 to January 2020. Information on age, gender, methadone daily doses and serum concentrations, subjective opioid withdrawal symptoms using 16 items Subjective Opioid Withdrawal Scale (SOWS) questionnaire, self-reported adverse effects, and substance use was obtained. Linear mixed modelling was used for analyzing the data. The mean age of the participants was 45?years, and 33% were women. Almost half reported mild to moderate subjective opioid withdrawal symptoms, and all had experienced at least one subjective adverse effect. The use of at least one substance was reported by 88% of the participants. Serum concentration-to-dose ratios were lower among those who had reported subjective opioid withdrawal symptoms (p)?=?0.039). The total SOWS score (p??0.001); the specific subjective withdrawal symptoms of anxiety (p?=?0.004), bone and muscle aches (p?=?0.003), restlessness (p?=?0.017), and (slightly) shaking (p?=?0.046), also use of heroin (p?=?0.015) and alcohol (p?=?0.011) were associated with lower methadone concentrations. Cannabis use was slightly related to higher methadone concentrations (p?=?0.049). The findings suggest that the patient’s self-perceived symptoms and current clinical condition are related to the serum concentrations of methadone. This interpretation supports dose adjustments based on patient-reported symptoms. In some aberrant cases, measurement of serum concentrations together with other individual assessments may be considered to support the clinical decision.
机译：关于如何优化患有阿甲酸啉成瘾患者的美沙酮剂量，几乎没有基于证据的指导。本研究旨在调查MMT患者的自我感知的阿片类药物戒断症状，​​不良影响和自我报告的用途与血清美沙酮浓度有关，这些变量在剂量调节的临床决策中可以发挥作用。这种自然主义前瞻性研究包括来自2017年5月至1月2020年5月到2020年5月到2020年5月到2020年5月到2020年代的83名患者的临床和实验室测量。关于年龄，性别，美沙酮日剂量和血清浓度，主观阿片类药物使用16项的患者主观阿片类药物戒断量表（母猪）问卷，自报告的不良反应和物质使用。线性混合建模用于分析数据。参与者的平均年龄为45岁，岁月33％是女性。几乎一半的报告的轻度至中度主观阿片类药物戒断症状，​​所有这些都经历了至少一种主观不良影响。 88％的参与者报告了至少一种物质的使用。报告主观阿片类药物戒断症状的人（P）= 0.039），血清浓度与剂量比率较低。总幅度得分（P？＆？0.001）;焦虑的具体主观戒断症状（p？= 0.004），骨骼和肌肉疼痛（p？= 0.003），躁动（p？= 0.017），并且（略）摇动（p？= 0.046），也使用海洛因（p？= 0.015）和醇（p？= 0.011）与下巴酮浓度有关。大麻用与较高的美沙酮浓度略微相关（P？= 0.049）。研究结果表明，患者的自我感知症状和目前的临床病症与美沙酮的血清浓度有关。这种解释支持基于患者报告的症状进行剂量调整。在一些异常的情况下，可以认为血清浓度与其他个体评估一起用于支持临床决策。

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