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https://hdl.handle.net/2440/14398
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Type: | Journal article |
Title: | Evaluation of levo-alpha-acetylmethdol (LAAM) as an alternative treatment for methadone maintenance patients who regularly experience withdrawal: a pharmacokinetic and pharmacodynamic analysis |
Author: | Newcombe, D. Bochner, F. White, J. Somogyi, A. |
Citation: | Drug and Alcohol Dependence, 2004; 76(1):63-72 |
Publisher: | Elsevier Sci Ireland Ltd |
Issue Date: | 2004 |
ISSN: | 0376-8716 1879-0046 |
Statement of Responsibility: | David A. L. Newcombe, Felix Bochner, Jason M. White and Andrew A. Somogyi |
Abstract: | The aim of this study was to determine if substitution of daily methadone with second daily levo-alpha-acetylmethadol (LAAM) would convert non-holders on methadone into holders on LAAM, and to compare plasma concentration–time profiles of (R)-methadone with LAAM and its two metabolites. Sixteen stable methadone maintenance treatment participants (non-holders, n=8) were randomly allocated to continue methadone for 3 months or switch to LAAM for 3 months, and then crossed over to the alternative drug for 3 months. At steady state, there were two testing sessions (24 h for methadone and 48 h for LAAM), during which opioid withdrawal severity, respiration rate and pupil diameter were measured 10–11 times and venous blood was collected 13–15 times. Ten age- and gender-matched controls underwent one 48-h test session. Areas under the withdrawal severity score versus time curve (AUC0–47 hours for LAAM and controls; AUC0–24 × 2 for methadone) were similar in holders on methadone and LAAM (P=0.62), but were greater in non-holders when they were taking methadone than LAAM (P<0.001). Respiratory depression and pupillary constriction were similar for LAAM and methadone. In comparison to (R)-methadone, plasma nor- and dinor-LAAM concentrations fluctuated little over the dosing interval. LAAM converted methadone non-holders into LAAM holders. LAAM may therefore be useful in selected MMT non-holders and improve retention in opioid treatment programs. |
Keywords: | Methadone LAAM holders non-holders pharmacokinetics pharmacodynamics |
DOI: | 10.1016/j.drugalcdep.2004.04.004 |
Description (link): | http://www.elsevier.com/wps/find/journaldescription.cws_home/506052/description#description |
Published version: | http://dx.doi.org/10.1016/j.drugalcdep.2004.04.004 |
Appears in Collections: | Aurora harvest 7 Pharmacology publications |
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