title: [Psychiatric disorders associated with high-dose methadone (>100 mg/d): a retrospective analysis of treated patients].
abstract: BACKGROUND
  Recent studies show that high-dose methadone (>100 mg/d) allow a better control of the consumptions of illicit opiates by treated patients.
  
  
  OBJECTIVE
  The aim of this retrospective study was to analyze data of patients requiring high-dose methadone (>100 mg/d) as well as associated factors.
  
  
  METHODS
  We retrospectively reviewed charts of treated patients with high-dose methadone followed in the maintenance methadone treatment center between 01/01/07 and 01/07/10. The following variables (medical history, psychiatric comorbidities, associated drugs, and polyaddictions), were assessed with high-dose methadone, using an univariate and then a multavariate analysis. The threshold value of 130 mg/day (median of maximal daily dose) was used to perform analysis.
  
  
  RESULTS
  During the study period, 78 patients, mainly men (75.6%), with a median age of 34 years [22-57] were included. The both groups with posology of methadone ≤ 130 mg/d (n=44) versus posology of methadone >130 mg/d (n=34) were close in term of demographic characteristics, consumption of drugs and associated treatments. Plasma methadone concentrations were higher in patients with the daily doses of methadone superior than 130 mg/d (NS), as well as the methadone metabolite (EDDP, p=0.048). Among studied factors, the presence of psychiatric comorbidities was significantly associated with high-dose methadone (threshold 130 mg/d) [OR 4,6 IC 95% (1.412;14.925)]. Seven patients presented with complications related to methadone: cardiac disorder (3), libido troubles (3) and hypofertility (1).
  
  
  CONCLUSIONS
  Patients requiring high-dose methadone are polydrug addicts. In our study, patients with psychiatric comorbidities needed daily dose of methadone significantly more raised.
authors.affiliation: Service de Pharmacologie médicale et Toxicologie, Centre d'Addictovigilance, Hôpital Lapeyronie, CHU Montpellier, UM1, Montpellier, France.
authors.forename: Céline
authors.initials: C
authors.lastname: Eiden
authors.forename: Yves
authors.initials: Y
authors.lastname: Leglise
authors.forename: Béatrice
authors.initials: B
authors.lastname: Clarivet
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Blayac
authors.forename: Hélène
authors.initials: H
authors.lastname: Peyrière
mesh_terms: D000328:Adult; D015331:Cohort Studies; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006331:Heart Diseases / Q000139:chemically induced; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D008691:Methadone / Q000008:administration & dosage* / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D015999:Multivariate Analysis; D009294:Narcotics / Q000009:adverse effects* / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000150:complications* / Q000523:psychology / Q000534:rehabilitation*; D012189:Retrospective Studies; D012735:Sexual Dysfunction, Physiological / Q000139:chemically induced; D016320:Substance Abuse Treatment Centers; D055815:Young Adult
chemical_list: D009294:Narcotics; D008691:Methadone