Methadone: A Flicker Of Light In The Dark

Methadone: A Flicker Of Light In The Dark

To provide a better understanding of the very important role methadone plays in the treatment of addiction.
 
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 Does Methadone Formulation Make A Difference?

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PostSubject: Does Methadone Formulation Make A Difference?   Thu Jun 04, 2009 3:42 pm

What is better: Methadone as a liquid, tablet, or disket?


Practitioners and patients in the methadone maintenance field often have debated that question and opinions have varied. owever, clinical research reported in 1999 supports the notion that there really is no significant difference.
Investigators at Albert Einstein College of Medicine, Bronx, NY, enrolled 18 patients in an experiment whereby each received either methadone liquid, tablets, or diskets for a period of 3 weeks and was then switched to one of the other formulations. Each patient ended up receiving each of the 3 methadone formulations for 3 weeks in random order.
Patients and investigators were blinded; that is, methadone was dissolved in liquid in every case so they did not know if the original formulation was liquid or solid (tablet or disket). Serial blood samples were taken to measure serum methadone levels and assessments of subjective withdrawal symptoms were used to rate the effectiveness of each methadone preparation.
The [/size][/size]median methadone dose was 70 mg/day (range 30-100 mg/d). As the graph shows, there were no statistically significant differences in median methadone blood levels among the 3 formulations during a 24-hour dosing period, although methadone liquid appeared to persist at a higher therapeutic level throughout the day.

Furthermore, patient-reported subjective opioid withdrawal symptoms did not differ by methadone formulation. The authors concluded that patient intolerance to changes in methadone formulation, which are sometimes observed clinically, appear to have no basis in the pharmacologic action of methadone itself,whether in liquid or solid forms.

Therefore,any difficulties attributed solely to a particular methadone formulation may be due more to psychosocial factors.
[size=12][size=12][size=12]
See
: Gourevitch MN, Hartel D, Tenore P, Freeman K, Marion I, Hecht J, Lowinson J. Three oral formulations of methadone. A clinical and pharmacodynamic comparison. J Substance Abuse Treatment. 1999;17(3):237-241.


[/size]
[/size][/size]It should be noted that all patients in this study were abstinent from illicit or prescribed drugs and free of illnesses that might affect methadone metabolism. No patients received more than 100 mg/d of methadone, although serum trough levels (low-point values) were within a moderate therapeutic range (150-400 ng/mL)
for all of them. However, serum levels were only modestly correlated with individual methadone doses andthere were many differences across patients. Further studies enrolling more patients and in typical clinical settings, including patients requiring greater than 100 mg/d of methadone, would be a helpful expansion of this research. Finally, it should be noted that methadone formulations outside the United States are sometimes quite different, with some liquid preparations containing alcohol along with different sweetening agents and/or preservatives. Therefore, studies from other countries of patients’ tolerance of methadone formulations may not be directly comparable with those in the U.S. -Ed.]
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PostSubject: Re: Does Methadone Formulation Make A Difference?   Sat Jun 06, 2009 10:32 am

Deborah
I just posted to your post. But it didn't go through. I got the message that the servers were too busy to process my request.
What I was saying is that, this is an interesting observation.
In the case of my clinic they dosed the patients that were construction workers or landscapers, anyone that worked out in the sun, with the Diskette.
They were told the Diskette held them longer than the liquid. If they gave a person that was used to using the Diskette the liquid. The patients would swear there liquid wore off a lot sooner than the Diskette.
So this is a case of Mind over matter?
That is interesting. The mind is a powerful tool.
If only addiction could be a case of mind over matter instead of a disease. Life would be a lot simpler.
Thanks for the post and for all that you do.
Yours,
Dee


"I will let yesterday end so that today can begin"



Never take any online advice over that of a qualified healthcare provider
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PostSubject: Re: Does Methadone Formulation Make A Difference?   Wed Aug 26, 2009 10:10 am

hey yall!
i don't know whether or not liquid or diskette works longer. maybe it depends on the individual or it could be psychosomatic. but i do know that when i switched from diskette to liquid about 5 months ago, i could tell a difference. i switched because the diskettes were orange & for some reason that orange taste made me really sick. i would throw it up within 15 minutes of taking it, therefore not getting any in my system & withdrawing. i was immediately switched to liquid the day i got sick in front of my doctor. i don't know if it's me or the other meds i take, but i do know that my liquid doesn't last the full 24 hours. of course i am on seizure meds & that could have something to do w/ it. i am also going up slowly, so maybe it could just be the timing - i needed a higher dose & i got switched to liquid at the same time. there are so many different factors to weigh in on diskette vs. liquid vs. tablet. i just guess people should go for what works best for them. if i could take diskette, i probably would. but all the info you read says there is no difference so.... anyways this is just my problem. thanks for bring up the topic Deborah!
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