Feasability and safety of transfer from racemic methadone to (R)-methadone in primary care: clinical results from an open study.
Methadone is a proven first-line treatment in opioid dependence but few studies have addressed the efficacy of different isoforms of methadone or the transfer from one form to the other. This was a 4-week open study to examine the feasibility and safety of transfer from racemic methadone to (R)-methadone in primary care patients. A total of 1552 opioid-dependent patients formerly treated with racemic methadone were included and followed for 4 weeks after transfer to (R)-methadone. There were few drop-outs, and 1426 patients (91.9%) completed the 4-week transfer period. There were few adverse events or side effects and no deaths occurred during treatment. The number of drug-positive urine screens decreased from 61.2 to 39.8%. Withdrawal symptoms, craving and compliance improved significantly after transfer to (R)-methadone. We conclude that transfer from racemic to (R)-methadone is a safe and practical procedure.
Soyka
Michael
M
Psychiatric Hospital, University of Munich, Munich, Germany. michael.soyka@privatklinik-meiringen.ch
Zingg
Christina
C
D000328:Adult; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008691:Methadone / Q000009:adverse effects / Q000627:therapeutic use*; D009294:Narcotics / Q000009:adverse effects / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000534:rehabilitation; D010349:Patient Compliance / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000379:methods*; D011446:Prospective Studies; D013237:Stereoisomerism; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy / Q000534:rehabilitation
D009294:Narcotics; D008691:Methadone