Neuropsychological functioning in buprenorphine maintained patients versus abstinent heroin abusers on naltrexone hydrochloride therapy

Rationale Methadone and buprenorphine are among the most widely employed pharmacological treatments currently available for opioid addiction. Cognitive effects of buprenorphine in abstinent heroin abusers are nevertheless far from being understood. Methods Neuropsychological performance of 18 bupren...

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Published in:Human psychopharmacology 2009-10, Vol.24 (7), p.524-531
Main Authors: Messinis, Lambros, Lyros, Epameinondas, Andrian, Virginia, Katsakiori, Paraskevi, Panagis, George, Georgiou, Vasileios, Papathanasopoulos, Panagiotis
Format: Article
Language:English
Subjects:
Adult
buprenorphine
Buprenorphine - pharmacology
Buprenorphine - therapeutic use
Cognition Disorders - drug therapy
Cognition Disorders - etiology
Female
Heroin Dependence - complications
Heroin Dependence - drug therapy
Heroin Dependence - psychology
Humans
maintenance
Male
Mental Recall - drug effects
Middle Aged
naltrexone
Naltrexone - pharmacology
Naltrexone - therapeutic use
Narcotic Antagonists - pharmacology
Narcotic Antagonists - therapeutic use
neuropsychological
Neuropsychological Tests
Psychomotor Performance - drug effects
Verbal Learning - drug effects
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Summary:Rationale Methadone and buprenorphine are among the most widely employed pharmacological treatments currently available for opioid addiction. Cognitive effects of buprenorphine in abstinent heroin abusers are nevertheless far from being understood. Methods Neuropsychological performance of 18 buprenorphine‐maintained patients (BMP) was evaluated relative to that of 32 currently abstinent heroin abusers on naltrexone hydrochloride therapy (FHAN), and 34 non‐drug dependent controls. The three groups were demographically balanced. Clinical groups reported histories of similar patterns of drug use and had increased periods of abstinence from any illicit substance use including heroin. Results The BMP group performed poorer than controls on the RAVLT (encoding and delayed recall of verbal information), CTT (conceptual flexibility, executive functions) and the RBANS figure copy (visual perception) and delayed recall of visual information. There were no significant differences in any of the cognitive measures between the BMP and FHAN groups or between the FHAN group and controls. Furthermore, the non‐differing percentage of abnormal cases between the two patient groups led us to infer that treatment with either BPM or FHAN is not accompanied by qualitative differences in the cognitive profiles of these patients. Conclusion Overall, results suggest that treatment with naltrexone in abstinent heroin abusers may result in less impairment of cognitive functions compared to treatment with buprenorphine. These findings are relevant for improved prognosis and treatment strategies in opioid dependence. Copyright © 2009 John Wiley & Sons, Ltd.
ISSN:0885-6222
1099-1077
DOI:10.1002/hup.1050