title: Memantine improves buprenorphine/naloxone treatment for opioid dependent young adults.
abstract: BACKGROUND
  Opioid use disorders are considered a serious public health problem among young adults. Current treatment is limited to long-term opioid substitution therapy, with high relapse rates after discontinuation. This study evaluated the co-administration of memantine to brief buprenorphine pharmacotherapy as a treatment alternative.
  
  
  METHODS
  13-week double-blind placebo-controlled trial evaluating 80 young adult opioid dependent participants treated with buprenorphine/naloxone 16-4mg/day and randomized to memantine (15mg or 30mg) or placebo. Primary outcomes were a change in the weekly mean proportion of opioid use, and cumulative abstinence rates after rapid buprenorphine discontinuation on week 9.
  
  
  RESULTS
  Treatment retention was not significantly different between groups. The memantine 30mg group was significantly less likely to relapse and to use opioids after buprenorphine discontinuation. Among participants abstinent on week 8, those in the memantine 30mg group (81.9%) were significantly less likely to relapse after buprenorphine was discontinued compared to the placebo group (30%) (p<0.025). Also, the memantine 30mg group had significantly reduced opioid use (mean=0, SEM±0.00) compared to the placebo group (mean=0.33, SEM±0.35; p<0.004) during the last 2 weeks of study participation.
  
  
  CONCLUSIONS
  Memantine 30mg significantly improved short-term treatment with buprenorphine/naloxone for opioid dependent young adults by reducing relapse and opioid use after buprenorphine discontinuation. Combined short-term treatment with buprenorphine/naloxone may be an effective alternative treatment to long-term methadone or buprenorphine maintenance in young adults.
authors.affiliation: Division of Addiction Psychiatry, University of Massachusetts Medical School, USA; VA Central Western Massachusetts Healthcare System, USA; MAYU of New England, USA. Electronic address: gerardo.gonzalez@umassmed.edu.
authors.forename: Gerardo
authors.initials: G
authors.lastname: Gonzalez
authors.affiliation: Division of Addiction Psychiatry, University of Massachusetts Medical School, USA; College of the Holy Cross, USA.
authors.forename: Gregory
authors.initials: G
authors.lastname: DiGirolamo
authors.affiliation: Division of Addiction Psychiatry, University of Massachusetts Medical School, USA; MAYU of New England, USA.
authors.forename: Mauricio
authors.initials: M
authors.lastname: Romero-Gonzalez
authors.affiliation: Division of Addiction Psychiatry, University of Massachusetts Medical School, USA.
authors.forename: David
authors.initials: D
authors.lastname: Smelson
authors.affiliation: Division of Addiction Psychiatry, University of Massachusetts Medical School, USA.
authors.forename: Douglas
authors.initials: D
authors.lastname: Ziedonis
authors.affiliation: Division of Addiction Psychiatry, University of Massachusetts Medical School, USA.
authors.forename: Monika
authors.initials: M
authors.lastname: Kolodziej
mesh_terms: D000293:Adolescent; D000328:Adult; D000069479:Buprenorphine, Naloxone Drug Combination / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008559:Memantine / Q000627:therapeutic use*; D009270:Naloxone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment / Q000379:methods*; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D012008:Recurrence; D055815:Young Adult
chemical_list: D000069479:Buprenorphine, Naloxone Drug Combination; D009292:Narcotic Antagonists; D009270:Naloxone; D008559:Memantine
keywords: Buprenorphine; Early relapse; Memantine; Opioid dependence; Young adults