[Detoxification of poly-substance abusers with buprenorphine. Effects on affect, anxiety, and withdrawal symptoms].
We used an open-labeled, 21-day inpatient detoxification treatment to compare the short-term effects of a 10-day buprenorphine plus 19-day carbamazepine regimen (n = 15) to a 14-day oxazepam plus 19-day carbamazepine regimen (n = 12) during rapid detoxification from opioids and other abused drugs. Somatic and psychopathological changes were assessed using the following rating scales: ASI, HAMD, SCL-90-R, and SOWS. Eighteen of 27 patients (67%) completed the study. Four dropouts (27%) were treated with buprenorphine/carbamazepine (BPN/CBZ) and the other five dropouts (42%) were treated with oxazepam/carbamazepine (OXA/CBZ). Repeated measures analysis of variance showed that SOWS scores were significantly less pronounced with BPN-CBZ than with OXA/CBZ. On the first day of admission, no significant difference in HAMD scores was detected (BPN/CBZ 11.6, BPN/CBZ 1.0). On day 14, HAMD was significantly less pronounced in BPN/CBZ (3.0) than in OXA/CBZ (6.1). BPN/CBZ showed a significant improvement in the ASI score on days 7 and 14 compared with OXA/CBZ. Three of nine items of the SCL-90-R showed a trend toward less pronounced outcome in BPN-CBZ. No severe side effects occurred during treatment in either group. The buprenorphine/carbamazepine regimen provided significantly more effective relief from affect disturbances and withdrawal syndromes than the oxazepam/carbamazepine regimen. The pharmacological basis of these effects of buprenorphine (kappa-antagonism activity,mu-agonism activity) are discussed.
Paetzold
W
W
Abteilung Klinische Psychiatrie und Psychotherapie, Medizinische Hochschule Hannover.
Eronat
V
V
Seifert
J
J
Holze
I
I
Emrich
H M
HM
Schneider
U
U
D000328:Adult; D000339:Affect / Q000187:drug effects*; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use*; D000704:Analysis of Variance; D014151:Anti-Anxiety Agents / Q000627:therapeutic use; D001007:Anxiety / Q000188:drug therapy*; D002047:Buprenorphine / Q000627:therapeutic use*; D002220:Carbamazepine / Q000627:therapeutic use*; D002985:Clinical Protocols; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000188:drug therapy; D010076:Oxazepam / Q000627:therapeutic use; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy*; D019966:Substance-Related Disorders / Q000188:drug therapy* / Q000534:rehabilitation; D016896:Treatment Outcome
D018712:Analgesics, Non-Narcotic; D014151:Anti-Anxiety Agents; D009292:Narcotic Antagonists; D002220:Carbamazepine; D002047:Buprenorphine; D010076:Oxazepam