title: Cardiac autonomic modulation during methadone therapy among heroin users: a pilot study.
abstract: BACKGROUND
  Methadone therapy benefits heroin users in both the medical and psychosocial dimensions. However, both heroin and methadone have cardiac toxicity. Only limited information is available describing the changes in cardiac autonomic function of heroin users and effects of methadone therapy. We conduct the current study to explore the cardiac vagal function in heroin users as well as the impact of lapse and methadone therapy.
  
  
  METHODS
  80 heroin users from a methadone therapy clinic were distributed into 31 compliant and 49 incompliant patients according to whether they lapsed into heroin use within 10 days. 40 healthy control subjects were recruited from the community. Participants underwent electrocardiographic recordings and the heroin users were further investigated before and after methadone therapy. Spectral analysis of heart rate variability (HRV) was computed for cardiac parasympathetic modulation (high-frequency power, HF) and cardiac sympathetic modulation (normalized low-frequency power, LF%).
  
  
  RESULTS
  The baseline HRV parameters found lower HF values for heroin users and lower RR interval values for patients with a recent lapse compared with the healthy control subjects. After 1h of methadone administration, heroin users who had lapsed showed a significant increase in HF but the heroin users who had not lapsed did not.
  
  
  CONCLUSIONS
  Our findings suggest that heroin users show decreased cardiac vagal activity and that methadone therapy immediately facilitates vagal regulation in patients with a recent lapse. The differential patterns of autonomic alteration under methadone between those with and without lapse might offer an objective measure of lapse.
authors.affiliation: Department of Psychiatry, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan.
authors.forename: Li-Ren
authors.initials: LR
authors.lastname: Chang
authors.forename: Yu-Hsuan
authors.initials: YH
authors.lastname: Lin
authors.forename: Terry B J
authors.initials: TB
authors.lastname: Kuo
authors.forename: Yen-Cheng
authors.initials: YC
authors.lastname: Ho
authors.forename: Shiuan-Horng
authors.initials: SH
authors.lastname: Chen
authors.forename: Hung-Chieh
authors.initials: HC
authors.lastname: Wu Chang
authors.forename: Chih-Min
authors.initials: CM
authors.lastname: Liu
authors.forename: Cheryl C H
authors.initials: CC
authors.lastname: Yang
mesh_terms: D000328:Adult; D001341:Autonomic Nervous System / Q000187:drug effects* / Q000502:physiology; D001794:Blood Pressure / Q000187:drug effects* / Q000502:physiology; D004562:Electrocardiography / Q000187:drug effects / Q000379:methods; D005260:Female; D006339:Heart Rate / Q000187:drug effects* / Q000502:physiology; D006556:Heroin Dependence / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008691:Methadone / Q000494:pharmacology / Q000627:therapeutic use*; D010865:Pilot Projects; D014630:Vagus Nerve / Q000187:drug effects / Q000502:physiology
chemical_list: D008691:Methadone