A Placebo-Controlled Trial of Dextromethorphan as an Adjunct in Opioid-Dependent Patients Undergoing Methadone Maintenance Treatment

作者：Lee Sheng Yu; Chen Shiou Lan; Chang Yun Hsuan; Chu Chun Hsien; Chen Shih Heng; Chen Po See; Huang San Yuan; Tzeng Nian Sheng; Wang Liang Jen; Lee I Hui; Wang Tzu Yun; Chen Kao Chin; Yang Yen Kuang; Hong Jau Shyong; Lu Ru Band^*

来源：International Journal of Neuropsychopharmacology, 2015, 18(7): pyv008-pyv008.

DOI：10.1093/ijnp/pyv008

• cytokine
• dextromethorphan
• methadone maintenance therapy
• opioid dependence Dextromethorphan
• Heroin
• Cytokines

Background: Low-dose dextromethorphan (DM) might have anti-inflammatory and neurotrophic effects mechanistically remote from an NMDA receptor. In a randomized, double-blind, controlled 12 week study, we investigated whether add-on dextromethorphan reduced cytokine levels and benefitted opioid-dependent patients undergoing methadone maintenance therapy (MMT).
Methods: Patients were randomly assigned to a group: DM60 (60 mg/day dextromethorphan; n = 65), DM120 (120 mg/day dextromethorphan; n = 65), or placebo (n = 66). Primary outcomes were the methadone dose required, plasma morphine level, and retention in treatment. Plasma tumor necrosis factor (TNF)-alpha, C-reactive protein, interleukin (IL)-6, IL-8, transforming growth factor-beta 1, and brain-derived neurotrophic factor (BDNF) levels were examined during weeks 0, 1, 4, 8, and 12. Multiple linear regressions with generalized estimating equation methods were used to examine the therapeutic effect.
Results: After 12 weeks, the DM60 group had significantly longer treatment retention and lower plasma morphine levels than did the placebo group. Plasma TNF-alpha was significantly decreased in the DM60 group compared to the placebo group. However, changes in plasma cytokine levels, BDNF levels, and the methadone dose required in the three groups were not significantly different.
Conclusions: We provide evidence-decreased concomitant heroin use-of low-dose add-on DM's efficacy for treating opioid-dependent patients undergoing MMT.

• 单位
  长春大学; NIH