Effects of buprenorphine on opioid craving in comparison to other medications for opioid use disorder: A systematic review of randomized controlled trials.
Effects of buprenorphine on opioid craving in comparison to other medications for opioid use disorder: A systematic review of randomized controlled trials.
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与其他治疗阿片类药物使用障碍的药物相比，丁丙诺啡对阿片类药物渴望的影响：随机对照试验的系统评价。
DOI：
10.1016/j.addbeh.2022.107589
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发表时间：
2023
影响因子：
4.4
通讯作者：
Seal,Karen
中科院分区：
文献类型：
--
作者：
Baxley,Catherine;Borsari,Brian;Reavis,JillV;Manuel,JenniferK;Herbst,Ellen;Becker,William;Pennington,David;Batki,StevenL;Seal,Karen
渴望是阿片类药物使用障碍（OUD）的一种令人痛苦的症状，可以通过药物治疗来缓解。丁丙诺啡是一种有效的mod，可以抑制渴望；然而，在治疗的早期阶段，停止治疗和重新使用阿片类药物是很常见的。通过开始丁丙诺啡的高风险时期，更多关于渴望反应的信息可能为如何更好地针对渴望提供有意义的信息，这反过来可能会提高结果。本系统综述研究了丁丙诺啡在诱导和维持治疗阶段对渴望的剂量和配方，并将其与其他mod（即美沙酮、缓释纳曲酮[XR-NTX]）的渴望反应进行了比较。方法检索spubmed、PsycInfo、Embase和Cochrane Central数据库，检索丁丙诺啡与安慰剂、各种丁丙诺啡配方/剂量或其他包含阿片类药物渴望测量的mod的随机试验。结果共纳入10项研究。随着时间的推移，丁丙诺啡和丁丙诺啡/纳洛酮（BUP/NAL）的渴望程度都比安慰剂低。在丁丙诺啡剂量较低和较高的患者中，渴望程度更大。与其他mod相比，在6项研究中，有3项研究表明丁丙诺啡或BUP/NAL比美沙酮更容易引起渴望。BUP/NAL比XR-NTX报告的渴望程度更高。随着时间的推移，丁丙诺啡和BUP/NAL会减少渴望，尽管其他mod可能会提供更大的渴望减少。尽管目前对渴望的测量存在相当大的差异，但对于接受mod治疗的个体，特别是在治疗早期，这可能是一个有价值的概念。
BackgroundCraving is a distressing symptom of opioid use disorder (OUD) that can be alleviated with medications for OUD (MOUD). Buprenorphine is an effective MOUD that may suppress craving; however, treatment discontinuation and resumed opioid use is common during the early phases of treatment. More information on the craving response through the high-risk period of initiating buprenorphine may provide meaningful information on how to better target craving, which in turn may enhance outcomes. This systematic review investigated buprenorphine doses and formulations on craving during the induction and maintenance phases of treatment, and for context also compared the craving response to other MOUD (i.e., methadone, extended-release naltrexone [XR-NTX]).MethodsPubMed, PsycInfo, Embase, and Cochrane Central databases were searched for randomized trials of buprenorphine versus placebo, various buprenorphine formulations/doses, or other MOUD that included a measure of opioid craving.ResultsA total of 10 studies were selected for inclusion. Buprenorphine and buprenorphine/naloxone (BUP/NAL) were each associated with lower craving than placebo over time. Craving was greater among those prescribed lower versus higher buprenorphine doses. In comparison to other MOUD, buprenorphine or BUP/NAL was linked to greater craving than methadone in 3 of the 6 studies. BUP/NAL was associated with greater reported craving than XR-NTX.DiscussionCraving is reduced over time with buprenorphine and BUP/NAL, although other MOUD may provide greater reductions in craving. Although there is currently considerable variability in the measurement of craving, it may be a valuable concept to address with individuals receiving MOUD, especially early in treatment.