Association of CYP2D6 ultrarapid metabolizer genotype with deficient patient satisfaction regarding methadone maintenance treatment.
OBJECTIVE
The activity of cytochrome P-450 enzyme 2D6 (CYP2D6) could be related to heroin-dependent patient satisfaction with methadone maintenance treatment. We sought to compare satisfaction with the usual methadone treatment in patients who are ultrarapid, extensive or poor metabolizers, according to CYP2D6 genotyping.


METHODS
Two hundred and five heroin-dependent patients filled out the Verona Service Satisfaction Scale for methadone maintenance treatment (VSSS-MT), before CYP2D6 genotyping.


RESULTS
VSSS-MT overall scores were comparable in the poor metabolizer (N=9) and extensive metabolizer (N=185) groups, although they were higher in poor metabolizers and extensive metabolizers taken together than in the ultrarapid metabolizers (N=11) (p<0.003). Likewise, ultrarapid metabolizers scored higher than the rest of the sample on the VSSS-MT Basic Interventions subscale (p<001). Regarding this subscale, no poor metabolizers felt dissatisfied, and ultrarapid metabolizer males (N=7) reported lower satisfaction than ultrarapid metabolizer females (N=4) (p<0.022). Ultrarapid metabolizer genotype accounted for 4.2% of the variance on the VSSS-MT total scores, and 5.0% on the Basic Intervention scores.


CONCLUSIONS
Heroin-dependent patients who are CYP2D6 ultrarapid metabolizers according to genotyping present deficient satisfaction with methadone maintenance treatment.
Pérez de los Cobos
José
J
Addictive Behaviors Unit (Psychiatry Department), Hospital de la Santa Creu i Sant Pau, Avda Sant Antoni M. Claret 167, 08025 Barcelona, Spain. jperezc@santpau.es
Siñol
Núria
N
Trujols
Joan
J
del Río
Elisabeth
E
Bañuls
Enrique
E
Luquero
Elena
E
Menoyo
Anna
A
Queraltó
Josep Maria
JM
Baiget
Montserrat
M
Alvarez
Enric
E
D000328:Adult; D019389:Cytochrome P-450 CYP2D6 / Q000235:genetics*; D005260:Female; D005787:Gene Frequency / Q000235:genetics; D005838:Genotype; D006556:Heroin Dependence / Q000097:blood / Q000235:genetics* / Q000523:psychology / Q000534:rehabilitation; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D008657:Metabolic Clearance Rate / Q000235:genetics / Q000502:physiology; D008691:Methadone / Q000493:pharmacokinetics* / Q000627:therapeutic use; D008875:Middle Aged; D009294:Narcotics / Q000493:pharmacokinetics* / Q000627:therapeutic use; D017060:Patient Satisfaction; D012737:Sex Factors; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D016312:Treatment Refusal / Q000523:psychology
D013287:Illicit Drugs; D009294:Narcotics; D019389:Cytochrome P-450 CYP2D6; D008691:Methadone