HOW TO INTERPRET A PEAK AND TROUGH TEST

Any of us on MMT have more than likely heard of a Peak and Trough test. Especially if you have wanted to increase you dose past a certain point (usually anything above 120mg a day) than your clinic thinks is "safe".

Not everyone knows how to interpret those results and this is ESPECIALLY a problem when your own clinic and/or doctor doesn't know how to interpret them.


The main thing I do want to point out is that it clearly states that a PATIENT'S CLINICAL PRESENTATION SHOULD OVERRIDE ANY TEST RESULTS NO MATTER WHAT THE RESULTS SAY. This means that just because the results may "look" within normal range, does not mean that the patient is on a stable dose. the doctor should take into consideration any physical withdrawal symptoms you may be exhibiting as well as what the patient is saying. Basically, the chart is a guideline and not a hard and fast definate rule.

Interpreting Methadone Serum Methadone Levels


Trough level < 200ng/ml Subtherapeutic; withdrawal likely.
> 200-400ng/ml Sometimes little or no withdrawal,but opioid
blockade probably incomplete.
> 400-500ng/ml Optimal, usually no withdrawal and opioid
blockade achieved.
>500-700ng/ml Withdrawal unlikely, but possible monitor
clinically for overmedication.
>700ng/ml Withdrawal unlikely, examine other reasons for
any discomfort (and monitor for overmedication).


Please ask for a copy of your Serum Methadone Level. You have a right to a copy of any test included in your medical records.

Source:
Medical Assisted Treatment of America Website
Methadone And Pain Section/Peak and Trough