title: Dextromethorphan attenuated inflammation and combined opioid use in humans undergoing methadone maintenance treatment.
abstract: Recent studies show that proinflammatory cytokines might be related to the development of opioid dependence (physiological, psychological, or both). In a double-blind, randomly stratified clinical trial investigating whether add-on dextromethorphan (60-120 mg/day) attenuated inflammation and the combined use of opioids in heroin-dependent patients undergoing methadone maintenance treatment, we evaluated whether inflammation is related to the progression of opioid dependence. All participants (107 heroin-dependent patients and 84 nondependent healthy controls) were recruited from National Cheng Kung University Hospital. Their plasma cytokine levels were measured to evaluate the effect of add-on dextromethorphan. Plasma TNF-α and IL-8 levels were significantly higher in long-term heroin-dependent patients than in healthy controls (p < 0.001). Chronic heroin-use-induced TNF-α and IL-8 levels were significantly (p < 0.05) attenuated in patients treated for 12 weeks with add-on dextromethorphan. Moreover, both tolerance to methadone and the combined use of opioids were significantly (p < 0.05) attenuated in patients taking dextromethorphan. We conclude that dextromethorphan might be a feasible adjuvant therapeutic for attenuating inflammation and inhibiting methadone tolerance and combined opioid use in heroin-dependent patients.
authors.affiliation: Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Shiou-Lan
authors.initials: SL
authors.lastname: Chen
authors.forename: Sheng-Yu
authors.initials: SY
authors.lastname: Lee
authors.forename: Pao-Luh
authors.initials: PL
authors.lastname: Tao
authors.forename: Yun-Hsuan
authors.initials: YH
authors.lastname: Chang
authors.forename: Shih-Heng
authors.initials: SH
authors.lastname: Chen
authors.forename: Chun-Hsien
authors.initials: CH
authors.lastname: Chu
authors.forename: Po See
authors.initials: PS
authors.lastname: Chen
authors.forename: I Hui
authors.initials: IH
authors.lastname: Lee
authors.forename: Tzung Lieh
authors.initials: TL
authors.lastname: Yeh
authors.forename: Yen Kuang
authors.initials: YK
authors.lastname: Yang
authors.forename: Jau-Shyong
authors.initials: JS
authors.lastname: Hong
authors.forename: Ru-Band
authors.initials: RB
authors.lastname: Lu
mesh_terms: D000328:Adult; D000661:Amphetamine / Q000097:blood / Q000652:urine; D019969:Amphetamine-Related Disorders / Q000097:blood / Q000652:urine; D000701:Analgesics, Opioid / Q000097:blood / Q000652:urine; D000697:Central Nervous System Stimulants / Q000097:blood / Q000652:urine; D003915:Dextromethorphan / Q000494:pharmacology*; D004311:Double-Blind Method; D005260:Female; D006556:Heroin Dependence / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D007249:Inflammation / Q000188:drug therapy*; D016209:Interleukin-8 / Q000097:blood; D008297:Male; D008691:Methadone; D008875:Middle Aged; D009020:Morphine / Q000097:blood / Q000652:urine; D058850:Opiate Substitution Treatment / Q000379:methods*; D055502:Secondary Prevention; D015813:Substance Abuse Detection; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D000697:Central Nervous System Stimulants; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; D003915:Dextromethorphan; D009020:Morphine; D000661:Amphetamine; D008691:Methadone