Methadone Maintenance Dosing Guideline for Opioid Dependence, a Literature Review
Methadone Maintenance Dosing Guideline for Opioid Dependence, a Literature Review
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DOI：
10.1080/10550880903436010
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发表时间：
2010-01-01
影响因子：
2.3
通讯作者：
Drexler, Karen
中科院分区：
文献类型：
--
作者：
Fareed, Ayman;Casarella, Jennifer;Drexler, Karen
到目前为止，美沙酮剂量仍然是一个争论和争议的问题，在临床医生谁是参与美沙酮维持计划。作者进行了文献综述，以更新临床医生对这个问题，并提供适当的美沙酮剂量的建议。通过检索1990年至2008年9月期间发表的报告，使用主要医学主题美沙酮（所有领域）和剂量，从PubMed数据库中检索符合纳入审查的研究。仅包括用英语撰写的文章。从检索文章的参考文献列表中以及通过手动审查期刊引文报告2008年精神病学和药物滥用主题类别列表中包含的药物滥用期刊目录，识别出其他报告。排除医学会议摘要。24篇文章被纳入综述。12项为随机、对照或双盲临床试验，10项为非随机和观察性研究，2项为荟萃分析。目前，共识是美沙酮剂量的目标是每天60至100毫克。对于继续使用非法阿片类药物的患者，同时规定该剂量范围，临床医生可能会考虑剂量大于100 mg每日。然而，这不是目前的共识，而是基于作者有限的有希望的数据;如果某些患者的受益超过风险，则可以考虑。
To date, methadone dosing is still an issue of debate and controversy among clinicians who are involved in methadone maintenance programs. The authors conducted a literature review to update clinicians about this issue and provide recommendations for proper methadone dosing. Studies eligible for inclusion in the review were retrieved from the PubMed database by searching for reports published between 1990 and September 2008 using the major medical subject headings Methadone (all fields) and dose. Only articles written in English were included. Additional reports were identified from the reference lists of retrieved articles and by manual review of the tables of contents of journals on drug of abuse included in the psychiatry and substance abuse subject category listing 2008 of the Journal Citation Reports. Abstracts of medical meetings were excluded. Twenty-four articles were included in the review. Twelve are randomized, controlled, or double-blind clinical trials, 10 are non-randomized and observational studies, and 2 are meta-analyses. Currently, the consensus is to have a goal for methadone dosing in the range of 60 to 100 mg daily. For patients who continue to use illicit opiates while prescribed this dose range, clinicians may consider doses greater than 100 mg daily. However, this is not the current consensus but rather is based on the limited promising data the authors have; it could be considered if the benefits outweigh the risks for some patients.