Search results for "methadone"
showing 10 items of 48 documents
Morphine versus methadone in the pain treatment of advanced-cancer patients followed up at home
1998
PURPOSE The aim of this study was to evaluate the analgesic and adverse effects and the doses of methadone in comparison to morphine. PATIENTS AND METHODS A prospective randomized study was performed in a sample of 40 patients with advanced cancer who required strong opioids for their pain management. Patients were treated with sustained-release morphine or methadone in doses titrated against the effect administered two or three times daily according to clinical need. Opioid doses, adjuvant medications, symptoms associated with opioid therapy, pain intensity, and pain mechanisms were recorded. The opioid escalation indices in percentage (OEI%) and milligrams (OEImg) were calculated. The eff…
Safety and tolerability of slow-release oral morphine versus methadone in the treatment of opioid dependence
2014
Opioid substitution treatment (OST) for opioid dependence may be limited by adverse events (AEs). Increasing the range of therapeutic options optimizes outcomes and facilitates patient management. An international, multi-center, two-phase study investigated the efficacy and safety of slow-release oral morphine (SROM) versus methadone in patients receiving methadone therapy for opioid dependence. In phase 1 (two way cross-over, 11 weeks each period) patients were randomized to SROM or methadone oral solution. In phase 2 (25 weeks), patients continued treatment with SROM (group A) or switched from methadone to SROM (group B). In total, 211 out of 276 completed phase 1 and 198 entered phase 2 …
A satisfaction survey of opioid-dependent clients at methadone treatment centres in Spain
2002
A survey was carried out to evaluate the satisfaction with methadone treatment centres of methadone-maintained opioid-dependent patients from Spain. Independent interviewers asked 505 consecutively arriving clients from 20 randomly selected centres (14 conventional centres, two bus units, and four prisons) to participate; 370 (73.3%) clients agreed to fill out the questionnaire, and 351 (69.5%) completed it. Satisfaction was assessed using the Verona Service Satisfaction Scale for methadone treatment (VSSS-MT). The prison sub-sample (n=43) was excluded from overall analysis because survey acceptance and satisfaction was very different in prisons than in the other centres. Mean overall satis…
Maintenance treatment for opioid dependence with slow‐release oral morphine: a randomized cross‐over, non‐inferiority study versus methadone
2012
Aims To compare the efficacy of slow-release oral morphine (SROM) and methadone as maintenance medication for opioid dependence in patients previously treated with methadone. Design Prospective, multiple-dose, open label, randomized, non-inferiority, cross-over study over two 11-week periods. Methadone treatment was switched to SROM with flexible dosing and vice versa according to period and sequence of treatment. Setting Fourteen out-patient addiction treatment centres in Switzerland and Germany. Participants Adults with opioid dependence in methadone maintenance programmes (dose ≥50 mg/day) for ≥26 weeks. Measurements The efficacy end-point was the proportion of heroin-positive urine samp…
Frequency, indications, outcomes, and predictive factors of opioid switching in an acute palliative care unit.
2007
The aim of this study was to prospectively evaluate the frequency, indications, outcomes, and predictive factors associated with opioid switching, using a protocol that had been clinically applied and viewed as effective for many years. A prospective study was carried out on a cohort of consecutive cancer patients who were receiving opioids but had an unacceptable balance between analgesia and adverse effects, despite symptomatic treatment of side effects. The initial conversion ratio between opioids and routes was as follows (mg/day): oral morphine 100=intravenous morphine 33=transdermal fentanyl 1=intravenous fentanyl 1=oral methadone 20=intravenous methadone 16=oral oxycodone 70=transder…
Opioid Plasma Concentrations during a Switch from Transdermal Fentanyl to Methadone
2007
Opioid switching is often used to improve the opioid response in patients with cancer experiencing poor analgesia or adverse effects. When switching between drugs with delayed effect because of pharmacokinetics or type of delivery, concerns exist about the correct timing of introducing the second drug after stopping the previous one. The aim of this study was to assess plasmatic changes of fentanyl and methadone underlying the clinical events occurring during opioid switching. Eighteen patients with cancer receiving transdermal fentanyl with uncontrolled pain and/or moderate to severe opioid adverse effects, were switched to oral methadone using an initial fixed ratio of 1:20. Fentanyl patc…
Patient perspectives on methadone maintenance treatment in the Valencia Region: dose adjustment, participation in dosage regulation, and satisfaction…
2005
Desired adjustment of methadone dose, perceived participation in dosage regulation, and satisfaction with methadone treatment centres were assessed in a sample of opioid-dependent patients from the Valencia Region (eastern Spain). An independent interviewer asked 278 consecutively arriving patients to answer the survey, and 165 (59.4%) completed it. Adjustment of methadone dose was assessed with a -10 to +10 visual analogue scale (VAS-MD); participation in methadone dose regulation, with specific questions; and patient satisfaction, with the Verona Service Satisfaction Scale for methadone treatment (VSSS-MT). The methadone dose (mg/d) prescribed by physicians was (mean+/-S.D.) 68.0+/-30.4. …
Exercise as an Adjuvant Intervention in Opiate Dependence
2013
We read with interest the article by Weinstock et al. in whichthe authors propose exercise as an adjuvant intervention inopiate agonist treatment based on current research findings(1).The use of an opiate agonist, such as buprenorphine, butmainly, methadone, for the treatment of opiate dependenceis currently an effective therapy for this type of addiction.The main benefits of this treatment occur through a relieffrom craving narcotic drugs, a temporally suppression ofwithdrawal symptoms, and by blocking the euphoric effectsof opiates (2). Unfortunately, patients needing treatment foropiatedependenceoftenfaceavarietyofco-occurringissues,suchashepatitisBandCvirusesorhumanimmunodeficiencyvirus (H…
Methadone as First-line Opioid for the Management of Cancer Pain
2022
Abstract Aim The aim of this study was to assess the efficacy and adverse effects of methadone when used as first-line therapy in patients that are either receiving low doses of opioids or none. Methods Patients with advanced cancer were prospectively assessed. Opioid-naive patients (L-group) were started with methadone at 6 mg/day. Patients receiving weak or other opioids in doses of <60 mg/day of OME (H-group) were started with methadone at 9 mg/day. Methadone doses were changed according to the clinical needs to obtain the most favorable balance between analgesia and adverse effects. Edmonton Symptom Asssement Score (ESAS), Memorial Delirium Assessment Score (MDAS), doses of metha…
O-18 - TDM in patients with substance related disorders
2012
The effect of pharmacotherapy of substance-related disorders is moderate at best. Therapeutic drug monitoring (TDM) could be an instrument to improve the outcomes. Since TDM for these drugs is not well established, the authors built a literature based rating scale to evaluate the necessity of TDM for the use of these pharmacological agents. Methods A literature research was performed for acamprosate, bupropion, buprenorphine, clomethiazole, disulfiram, methadone, naltrexone, and varenicline. A rating scale including 22 items, divided in five categories (efficacy, toxicity, pharmacokinetics, patient characteristics and cost effectiveness) was established for evaluation and related to the amo…