title: Actigraphic measurements in opioid detoxification with methadone or buprenorphine.
abstract: The objective of the present naturalistic study was to assess the differential effects of opioid detoxification with methadone or buprenorphine on activity, circadian rhythm, and sleep. Forty-two consecutive inpatients with opiate addiction were switched to either methadone or buprenorphine and gradually tapered down over the course of 2 to 3 weeks. There were no significant differences in comedication (lofexidine, quetiapine, and valproic acid) between the methadone and buprenorphine groups. Patients in the methadone group showed 11% lower activity and were 24 minutes phase delayed as compared with buprenorphine-treated patients, whereas the latter had 2.5% lower sleep efficiency and 9% shorter actual sleep time. These significant group differences were most pronounced for the lowest doses (≤20% of maximum individual daily dose, ie, at the end of withdrawal representing late withdrawal effects). Furthermore, for the total sample, we found a significant decrease in the relative amplitude of the sleep-wake cycle and worsening of all actigraphic sleep parameters from the higher (100% to 20%) to the lowest doses (20% to 0%). The acrophase of the circadian rhythm displayed a phase advance (-88 minutes) from the highest (100% to 80%) to the lower doses (80% to 0%) in methadone-treated patients. Opioid tapering with methadone or buprenorphine leads to characteristic changes of the rest-activity cycle, but further study is required to validate these results.
authors.affiliation: Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria.
authors.forename: Edda
authors.initials: E
authors.lastname: Pjrek
authors.forename: Richard
authors.initials: R
authors.lastname: Frey
authors.forename: Angela
authors.initials: A
authors.lastname: Naderi-Heiden
authors.forename: Alexandra
authors.initials: A
authors.lastname: Strnad
authors.forename: Alexander
authors.initials: A
authors.lastname: Kowarik
authors.forename: Siegfried
authors.initials: S
authors.lastname: Kasper
authors.forename: Dietmar
authors.initials: D
authors.lastname: Winkler
mesh_terms: D056044:Actigraphy; D000328:Adult; D001317:Austria; D002047:Buprenorphine / Q000009:adverse effects / Q000627:therapeutic use*; D002940:Circadian Rhythm / Q000187:drug effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008691:Methadone / Q000009:adverse effects / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment; D012890:Sleep / Q000187:drug effects
chemical_list: D002047:Buprenorphine; D008691:Methadone