Transferring methadone-stabilized pregnant patients to buprenorphine using an immediate release morphine transition: an open-label exploratory study.
A transition from methadone to buprenorphine without intervening withdrawal symptoms is critical for advancing the treatment of opioid-dependent patients. Four pregnant inpatients were transferred from methadone (65-85 mg) to five days of immediate release morphine (IRM) and then to buprenorphine (12-28 mg). Withdrawal scores decreased during the five days of IRM and subsequently increased over the first three days on buprenorphine. The transitional use of IRM appears safe for both mother and fetus. Withdrawal symptoms appeared during buprenorphine induction; however, these data suggest that the intensity of withdrawal symptoms may be lessened by the dose and frequency of buprenorphine administration.
Jones
Hendrée E
HE
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA. hejones@jhmi.edu
Suess
Patricia
P
Jasinski
Donald R
DR
Johnson
Rolley E
RE
D000328:Adult; D002047:Buprenorphine / Q000008:administration & dosage* / Q000009:adverse effects; D003692:Delayed-Action Preparations; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008691:Methadone / Q000008:administration & dosage* / Q000009:adverse effects; D009020:Morphine / Q000008:administration & dosage* / Q000009:adverse effects; D009292:Narcotic Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D009294:Narcotics / Q000008:administration & dosage* / Q000009:adverse effects; D009357:Neonatal Abstinence Syndrome / Q000517:prevention & control; D009460:Neurologic Examination / Q000187:drug effects; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000534:rehabilitation*; D011256:Pregnancy Outcome; D013375:Substance Withdrawal Syndrome / Q000517:prevention & control; D016896:Treatment Outcome
D003692:Delayed-Action Preparations; D009292:Narcotic Antagonists; D009294:Narcotics; D002047:Buprenorphine; D009020:Morphine; D008691:Methadone