A Placebo-Controlled Trial of Dextromethorphan as an Adjunct in Opioid-Dependent Patients Undergoing Methadone Maintenance Treatment

Sheng Yu Lee, Shiou Lan Chen, Yun Hsuan Chang, Chun Hsien Chu, Shih Heng Chen, Po See Chen, San Yuan Huang, Nian Sheng Tzeng, Liang Jen Wang, I. Hui Lee, Tzu Yun Wang, Kao Chin Chen, Yen Kuang Yang, Jau Shyong Hong, Ru Band Lu

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: Low-dose dextromethorphan (DM) might have anti-inflammatory and neurotrophic effects mechanistically remote from an NMDA receptor. In a randomized, double-blind, controlled 12 week study, we investigated whether add-on dextromethorphan reduced cytokine levels and benefitted opioid-dependent patients undergoing methadone maintenance therapy (MMT). Methods: Patients were randomly assigned to a group: DM60 (60 mg/day dextromethorphan; n = 65), DM120 (120 mg/day dextromethorphan; n = 65), or placebo (n = 66). Primary outcomes were the methadone dose required, plasma morphine level, and retention in treatment. Plasma tumor necrosis factor (TNF)-α, C-reactive protein, interleukin (IL)-6, IL-8, transforming growth factor-β1, and brain-derived neurotrophic factor (BDNF) levels were examined during weeks 0, 1, 4, 8, and 12. Multiple linear regressions with generalized estimating equation methods were used to examine the therapeutic effect. Results: After 12 weeks, the DM60 group had significantly longer treatment retention and lower plasma morphine levels than did the placebo group. Plasma TNF-α was significantly decreased in the DM60 group compared to the placebo group. However, changes in plasma cytokine levels, BDNF levels, and the methadone dose required in the three groups were not significantly different. Conclusions: We provide evidence-decreased concomitant heroin use-of low-dose add-on DM's efficacy for treating opioiddependent patients undergoing MMT.

Original languageEnglish
Pages (from-to)1-8
Number of pages8
JournalInternational Journal of Neuropsychopharmacology
Volume18
Issue number7
DOIs
Publication statusPublished - 2015 Jan 1

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Psychiatry and Mental health
  • Pharmacology (medical)

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