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Meyer M, Westenberg JN, Brunner P, Gürtler M, Wiesbeck GA, Lang UE, Vogel M, Dürsteler KM. Sexual dysfunction prevalence, risk factors, and help-seeking behavior in opioid agonist treatment and general psychiatry: a cross-sectional study. Front Psychiatry 2023; 14:1204236. [PMID: 37608998 PMCID: PMC10440384 DOI: 10.3389/fpsyt.2023.1204236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/25/2023] [Indexed: 08/24/2023] Open
Abstract
Background Mental disorders pose a high risk for the occurrence of sexual dysfunctions (SD). This study aimed to investigate prevalence of risk factors and help-seeking behavior for sexual dysfunctions in patients with opioid use disorder compared to patients seeking psychotherapeutic help. Methods Ninety-seven patients at two opioid agonist treatment (OAT) centers and 65 psychotherapeutic patients from a psychiatric practice (PP) in Switzerland were included in the study. Self-report assessments comprised sexual functioning (IIEF: International Index of Erectile Function; FSFI: Female Sexual Function Index), depressive state, psychological distress, alcohol consumption, nicotine use, and a self-designed questionnaire on help-seeking behavior. We used chi-squared and Mann-Whitney U tests for group comparisons and binary logistic regression models to identify variables predicting the occurrence of sexual dysfunctions. Results There was no statistically significant difference (p = 0.140) in the prevalence of SD between OAT (n = 64, 66.0%) and PP sample (n = 35, 53.8%). OAT patients scored significantly higher in scales assessing nicotine use (p < 0.001) and depressive state (p = 0.005). Male OAT patients scored significantly worse on the Erectile Function scale (p = 0.005) and female PP patients scored significantly worse on the FSFI Pain domain (p = 0.022). Opioid use disorder, higher age, and being female predicted the occurrence of SD in the total sample. In the OAT sample, only higher age remained predictive for the occurrence of SD. A lack of help-seeking behavior was observed in both groups, with only 31% of OAT patients and 35% of PP patients ever having talked about their sexual health with their treating physician. Conclusion SD are common among psychiatric patients receiving OAT and general psychiatric patients seeking psychotherapy. Professionals providing mental healthcare to patients must emphasize prevention and routine assessments of sexual functioning needs.
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Affiliation(s)
- Maximilian Meyer
- Clinic for Adult Psychiatry, University Psychiatric Clinics, University of Basel, Basel, Switzerland
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Jean N. Westenberg
- Clinic for Adult Psychiatry, University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Patrick Brunner
- Clinic for Adult Psychiatry, University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Martin Gürtler
- Health Center Allschwil (Gesundheitszentrum Allschwil AG), Allschwil, Switzerland
| | | | - Undine E. Lang
- Clinic for Adult Psychiatry, University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Marc Vogel
- Clinic for Adult Psychiatry, University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Kenneth M. Dürsteler
- Clinic for Adult Psychiatry, University Psychiatric Clinics, University of Basel, Basel, Switzerland
- Department for Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
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Meyer M, Brunner P, Geissmann L, Gürtler M, Schwager F, Waldis R, Vogel M, Wiesbeck GA, Dürsteler KM. Sexual Dysfunctions in Patients Receiving Opioid Agonist Treatment and Heroin-Assisted Treatment Compared to Patients in Private Practice-Identifying Group Differences and Predictors. Front Psychiatry 2022; 13:846834. [PMID: 35392381 PMCID: PMC8980546 DOI: 10.3389/fpsyt.2022.846834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Accepted: 02/25/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND AIMS Sexual dysfunctions (SDs) show a marked impact on a person's general wellbeing. Several risk-factors like physical and mental illnesses as well as alcohol and tobacco use have to date been identified to contribute to the occurrence of SDs. The impact of opioid-agonist treatment (OAT) on SDs remains unclear, with some studies demonstrating an improvement after methadone maintenance treatment (MMT) initiation. However, no studies on the prevalence and predictors of SDs in heroin-assisted treatment (HAT) exist to date. METHODS A cross-sectional study was conducted with patients from a MMT center (n = 57) and a center specializing in HAT (n = 47). A control group of patients with mild transient illnesses (n = 67) was recruited from a general practitioner (GP). The International Index of Erectile Function, the Female Sexual Function Index, as well as measurements for psychological distress, depressive state, nicotine dependence, and high-risk alcohol use were employed. Patients also completed a self-designed questionnaire on help-seeking behavior regarding sexual health. Mann-Whitney-U tests and chi-square tests were performed for group comparisons and binary logistic regression models were calculated. RESULTS Twenty-five percent of the GP sample (n = 17), 70.2% (n = 40) of the MMT sample, and 57.4% (n = 27) of the HAT sample suffered from SDs at the time of study conduction. OAT patients differed significantly from GP patients in depressive state, high-risk alcohol use, nicotine dependence, and psychological distress. Age, depressive state, and opioid dependence predicted the occurrence of SDs in the total sample. No differences between OAT and GP patients were found regarding help-seeking behavior. DISCUSSION Age, depressive state, and opioid dependence predicted the occurrence of SDs in the total sample. It remains unclear whether SDs are caused by opioid intake itself or result from other substance-use related lifestyle factors, that were not controlled for in this study. A lack of help-seeking behavior was observed in our sample, underlining the importance of clinicians proactively inquiring about the sexual health of their patients. CONCLUSION The high prevalence of SDs observed in MMT does not differ from the prevalence in HAT. Clinicians should actively inquire about their patients' sexual health in GP and OAT centers alike.
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Affiliation(s)
- Maximilian Meyer
- Clinic for Adult Psychiatry, University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Patrick Brunner
- Clinic for Adult Psychiatry, University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Leonie Geissmann
- Division of Cognitive Neuroscience, Department of Psychology, University of Basel, Basel, Switzerland
| | - Martin Gürtler
- Health Center Allschwil (Gesundheitszentrum Allschwil AG), Allschwil, Switzerland
| | - Fabienne Schwager
- Clinic for Adult Psychiatry, University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Rowena Waldis
- Clinic for Adult Psychiatry, University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Marc Vogel
- Clinic for Adult Psychiatry, University Psychiatric Clinics, University of Basel, Basel, Switzerland
| | - Gerhard A Wiesbeck
- Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Kenneth M Dürsteler
- Clinic for Adult Psychiatry, University Psychiatric Clinics, University of Basel, Basel, Switzerland.,Department for Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
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Afridi MB, Khan H, Shah SWA, Zafar M, Almalki ASA, Ghias M, Rahman N. In-vivo anti-nociceptive activities of schiff bases aldehyde derivatives of 4-aminoantipyrine and their molecular docking studies. MAIN GROUP CHEMISTRY 2021. [DOI: 10.3233/mgc-210099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In this study, the anti-nociceptive potential of Schiff bases derivatives of 4-aminoantioyrine, (Z)-4-(4-hydroxy-3-methoxybenzylideneamino)-2, 3-dimethyl-1-phenyl-1, 2dihydropyrazol-5-one 1 and (Z)-4-(2-nitrobenzylideneamino)-2, 3-dimethyl-1-phenyl-1-2-dihydropyrazol-5-one 2 were tested in various mice pain models and their binding affinities with different drug targets were evaluated through molecular docking studies. The binding scores were calculated through molecular docking techniques for receptor sensitivity. Acute toxicity test suggests the safety of both compounds up 200 mg/kg. In the righting test, compound 1 and 2 had a significant effect in a dose-dependent manner and showed 59.46% and 48.40% blockade of pain at 150 mg/kg, respectively. In the formalin test, dose-dependently compound 1 showed 52.95% and 62.02% of inhibition in the early and late phase at 150 mg/kg. Similarly, Compound 2 showed 45.74% and 55.95% inhibition in the early and late phases at 150 mg/kg, respectively. In the tail immersion test, both compounds caused significant pain inhibition during various assessment times with maximum effects at 74.94% and 66.80% for 1 and 2 respectively at 150 mg/kg after 120 min. In molecular docking studies, compounds 1 and 2 showed a greater affinity for LOX with a docking score of –6.50 and 6.57 respectively. Similarly, for compounds 1 and 2 the docking was –4.94 and –4.83 with COX-1 while –5.10 and –4.85 with COX-2, respectively. Taken together, both the compounds exhibited marked antinociceptive effects in various pain-induced models possibly mediated by inhibition of LOX and COX pathways.
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Affiliation(s)
| | - Haroon Khan
- Department of Pharmacy, Abdul Wali khan University Mardan, Pakistan
| | | | - Muhammad Zafar
- Department of Pharmacy, Abdul Wali khan University Mardan, Pakistan
| | | | - Mehreen Ghias
- Department of Pharmacy, University of Malakand, Chakdara, Dir, Pakistan
| | - Noor Rahman
- Department of Biochemistry, Abdul Wali khan University Mardan, Pakistan
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Afridi B, Khan H, Akkol EK, Aschner M. Pain Perception and Management: Where do We Stand? Curr Mol Pharmacol 2021; 14:678-688. [PMID: 32525788 PMCID: PMC7728656 DOI: 10.2174/1874467213666200611142438] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/18/2020] [Accepted: 04/29/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Pain is often flammable, sharp and sometimes described as an electrical shock. It can be categorized in three different ways as nociceptive, neuropathic and inflammatory. Nociceptive pain always originates in specific situations such as in trauma. Neuropathic pain results in nerve damage. In inflammatory pain, inflammatory mediators are involved in the sensitization of nociceptors. It is important to control the pain as it affects the individual physically, mentally, and socially. OBJECTIVE Recognizing pain physiopathology and pain pathways, defining the relationship between receptor and transmitter is critical in developing new treatment strategies. In this review, current information on the definitions, classifications, and physiological and chemical mechanisms involved in pain are reviewed. METHODS Various search engines were used to gather related articles/information. Only peer-reviewed journals were considered. Additional, books/chapters of standard publishers were also included in the article. RESULTS With a better understanding of the physiological and chemical mechanisms that play a role in pain, significant improvements have been made in pain treatment. Various oral or intravenous drugs, local injection treatments, physical and occupational therapy, electrical stimulation, alternative medicine applications, psychological support, and surgical applications are routinely performed in the treatment, dependent upon the type, severity and cause of the pain. CONCLUSION Improved understanding of pain physiopathology will serve as the basis for future improvements in the delivery of efficacious and reliable treatments, and is likely to rely on novel technological innovations.
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Affiliation(s)
- Bilal Afridi
- Department of Pharmacy, Abdul Wali Khan University Mardan 23200, Pakistan
| | - Haroon Khan
- Department of Pharmacy, Abdul Wali Khan University Mardan 23200, Pakistan
| | - Esra Kupeli Akkol
- Department of Pharmacognosy, Faculty of Pharmacy, Gazi University 06330, Etiler/Ankara, Turkey
| | - Michael Aschner
- Department of Molecular Pharmacognosy, Albert Einstein College of Medicine, Bronx, NY 10463, USA
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Bossert JM, Kiyatkin E, Korah H, Hoots JK, Afzal A, Perekopskiy D, Thomas S, Fredriksson I, Blough BE, Negus SS, Epstein DH, Shaham Y. In a Rat Model of Opioid Maintenance, the G Protein-Biased Mu Opioid Receptor Agonist TRV130 Decreases Relapse to Oxycodone Seeking and Taking and Prevents Oxycodone-Induced Brain Hypoxia. Biol Psychiatry 2020; 88:935-944. [PMID: 32305216 PMCID: PMC7483192 DOI: 10.1016/j.biopsych.2020.02.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 02/13/2020] [Accepted: 02/13/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Maintenance treatment with opioid agonists (buprenorphine, methadone) is effective for opioid addiction but does not eliminate opioid use in all patients. We modeled maintenance treatment in rats that self-administered the prescription opioid oxycodone. The maintenance medication was either buprenorphine or the G protein-biased mu opioid receptor agonist TRV130. We then tested prevention of oxycodone seeking and taking during abstinence using a modified context-induced reinstatement procedure, a rat relapse model. METHODS We trained rats to self-administer oxycodone (6 hours/day, 14 days) in context A; infusions were paired with discrete tone-light cues. We then implanted osmotic pumps containing buprenorphine or TRV130 (0, 3, 6, or 9 mg/kg/day) and performed 3 consecutive tests: lever pressing reinforced by oxycodone-associated discrete cues in nondrug context B (extinction responding), context-induced reinstatement of oxycodone seeking in context A, and reacquisition of oxycodone self-administration in context A. We also tested whether TRV130 maintenance would protect against acute oxycodone-induced decreases in nucleus accumbens oxygen levels. RESULTS In male rats, buprenorphine and TRV130 decreased extinction responding and reacquisition of oxycodone self-administration but had a weaker (nonsignificant) effect on context-induced reinstatement. In female rats, buprenorphine decreased responding in all 3 tests, while TRV130 decreased only extinction responding. In both sexes, TRV130 prevented acute brain hypoxia induced by moderate doses of oxycodone. CONCLUSIONS TRV130 decreased oxycodone seeking and taking during abstinence in a partly sex-specific manner and prevented acute oxycodone-induced brain hypoxia. We propose that G protein-biased mu opioid receptor agonists, currently in development as analgesics, should be considered as relapse prevention maintenance treatment for opioid addiction.
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Affiliation(s)
- Jennifer M. Bossert
- Behavioral Neuroscience Branch, IRP/NIDA/NIH, Baltimore, MD, U.S.A.,Correspondence: Jennifer M. Bossert ()
| | - Eugene Kiyatkin
- Behavioral Neuroscience Branch, IRP/NIDA/NIH, Baltimore, MD, U.S.A
| | - Hannah Korah
- Behavioral Neuroscience Branch, IRP/NIDA/NIH, Baltimore, MD, U.S.A
| | | | - Anum Afzal
- Behavioral Neuroscience Branch, IRP/NIDA/NIH, Baltimore, MD, U.S.A
| | | | - Shruthi Thomas
- Behavioral Neuroscience Branch, IRP/NIDA/NIH, Baltimore, MD, U.S.A
| | - Ida Fredriksson
- Behavioral Neuroscience Branch, IRP/NIDA/NIH, Baltimore, MD, U.S.A
| | - Bruce E. Blough
- Center for Drug Discovery, Research Triangle Institute, Research Triangle Park, NC, U.S.A
| | - S. Stevens Negus
- Dept. of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, U.S.A
| | - David H. Epstein
- Clinical Pharmacology and Therapeutics Research Branch, IRP/NIDA/NIH, Baltimore, MD, U.S.A
| | - Yavin Shaham
- Behavioral Neuroscience Branch, IRP/NIDA/NIH, Baltimore, MD, U.S.A
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Association Between Cognitive Impairment and Substance Use Disorder Attributed to Pregabalin in Egypt: A Case-Control Study. ADDICTIVE DISORDERS & THEIR TREATMENT 2020. [DOI: 10.1097/adt.0000000000000223] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Melbostad HS, Badger GJ, Rey CN, MacAfee LK, Dougherty AK, Sigmon SC, Heil SH. Contraceptive Knowledge among Females and Males Receiving Medication Treatment for Opioid Use Disorder Compared to Those Seeking Primary Care. Subst Use Misuse 2020; 55:2403-2408. [PMID: 33019893 PMCID: PMC7712494 DOI: 10.1080/10826084.2020.1823418] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Rates of unintended pregnancy among women receiving medication treatment for opioid use disorder (mOUD) are high, likely due in part to low rates of contraceptive use. Lack of knowledge about contraception may be contributing to inadequate contraceptive use. Objectives: To compare contraceptive knowledge among women and men receiving mOUD relative to a comparison group seeking primary care. Methods: We surveyed 332 reproductive-age women and men receiving mOUD or primary care with the recently validated 25-item Contraceptive Knowledge Assessment. We examined overall differences between patient groups and between females and males using two-way analyses of variance; individual item differences were tested using logistic regression. Results: The mean percent of total correct responses was lower among individuals receiving mOUD (n = 167) relative to the comparison group (n = 165), 47.7% vs. 53.8%, respectively (p < .001), and higher among females (n = 169) relative to males (n = 163), 56.1% vs. 45.2%, respectively (p < .001). Individual item analyses revealed patient group and sex differences primarily in the areas of contraceptive efficacy, attributes of contraceptive methods, and fertility awareness. Conclusion: While there were modest differences between patient groups and sexes, the results suggest a deficit in contraceptive knowledge across all groups. Substance use disorder treatment clinics could be an opportunistic setting in which to provide accurate information about contraception to patients with OUD and other substance use disorders.
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Affiliation(s)
- Heidi S. Melbostad
- Vermont Center on Behavior and Health, 1 South Prospect Street, UHC - OH3 MS 482, Burlington, VT, United States, 05401
- University of Vermont, Department of Psychological Science, 2 Colchester Avenue, John Dewey Hall, Room 248, Burlington, VT, United States, 05405
| | - Gary J. Badger
- Vermont Center on Behavior and Health, 1 South Prospect Street, UHC - OH3 MS 482, Burlington, VT, United States, 05401
| | - Catalina N. Rey
- Vermont Center on Behavior and Health, 1 South Prospect Street, UHC - OH3 MS 482, Burlington, VT, United States, 05401
- University of Vermont, Department of Psychiatry. 1 South Prospect Street, MS 446AR6, Burlington, VT, United States 05401
| | - Lauren K. MacAfee
- University of Vermont, Department of Obstetrics, Gynecology, and Reproductive Sciences, 111 Colchester Avenue, Smith 410, Burlington, VT, United States 05401
| | - Anne K. Dougherty
- University of Vermont, Department of Obstetrics, Gynecology, and Reproductive Sciences, 111 Colchester Avenue, Smith 410, Burlington, VT, United States 05401
| | - Stacey C. Sigmon
- Vermont Center on Behavior and Health, 1 South Prospect Street, UHC - OH3 MS 482, Burlington, VT, United States, 05401
- University of Vermont, Department of Psychological Science, 2 Colchester Avenue, John Dewey Hall, Room 248, Burlington, VT, United States, 05405
- University of Vermont, Department of Psychiatry. 1 South Prospect Street, MS 446AR6, Burlington, VT, United States 05401
| | - Sarah H. Heil
- Vermont Center on Behavior and Health, 1 South Prospect Street, UHC - OH3 MS 482, Burlington, VT, United States, 05401
- University of Vermont, Department of Psychological Science, 2 Colchester Avenue, John Dewey Hall, Room 248, Burlington, VT, United States, 05405
- University of Vermont, Department of Psychiatry. 1 South Prospect Street, MS 446AR6, Burlington, VT, United States 05401
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Fang CP, Liu TH, Chung RH, Tsou HH, Kuo HW, Wang SC, Liu CC, Liu SC, Chen ACH, Liu YL. Genetic variants in NECTIN4 encoding an adhesion molecule are associated with continued opioid use. PLoS One 2020; 15:e0234549. [PMID: 32555608 PMCID: PMC7302666 DOI: 10.1371/journal.pone.0234549] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 05/28/2020] [Indexed: 01/17/2023] Open
Abstract
Methadone is a synthetic opioid used as maintenance treatment for patients addicted to heroin. Skin irritation is one of the adverse events caused by opioid use. 344 methadone maintenance treatment (MMT) patients were recruited with records and measurements on methadone dose, plasma methadone concentrations, and treatment emergent symptom scales (TESS). 15 patients reported with skin irritation. Five SNPs located within the NECTIN4 genetic region were genotyped. The NECTIN4 gene within the adherens junction interaction pathway was associated with methadone dose in pathway-based genome wide association analyses (P = 0.0008). Three highly-linked SNPs, rs11265549, rs3820097, and rs4656978, were significantly associated with methadone dose (P = 0.0003), plasma concentrations of R,S-methadone (P = 0.0004) and TNF-α (P = 0.010) in all 344 MMT patients, and with self-report skin irritation symptom scores (P = 0.010) in the 15 MMT patients who reported with skin irritation. To identify the possible roles of plasma level of Nectin-4 in the responses to MMT and opioid use, additional age- and gender-matched 51 controls and 83 methadone-free abstinent former heroin users were recruited. Plasma level of Nectin-4 was the highest in MMT patients among the three groups. The results suggest involvement of genetic variants on NECTIN4 in methadone dose. Plasma Nectin-4 level is likely an indicator for continued use of opioids.
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Affiliation(s)
- Chiu-Ping Fang
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Tung-Hsia Liu
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Ren-Hua Chung
- Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
| | - Hsiao-Hui Tsou
- Division of Biostatistics and Bioinformatics, Institute of Population Health Sciences, National Health Research Institutes, Miaoli County, Taiwan
- Graduate Institute of Biostatistics, China Medical University, Taichung, Taiwan
| | - Hsiang-Wei Kuo
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Sheng-Chang Wang
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Chia-Chen Liu
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Shu Chih Liu
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
| | - Andrew C. H. Chen
- Department of Psychiatry, the Zucker Hillside Hospital, Northwell Health, Glen Oaks, New York, United States of America
- The Feinstein Institute for Medical Research, Hofstra Northwell School of Medicine at Hofstra University, Manhasset, New York, United States of America
| | - Yu-Li Liu
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Miaoli County, Taiwan
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
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Farnia V, Alikhani M, Ebrahimi A, Golshani S, Sadeghi Bahmani D, Brand S. Ginseng treatment improves the sexual side effects of methadone maintenance treatment. Psychiatry Res 2019; 276:142-150. [PMID: 31082749 DOI: 10.1016/j.psychres.2019.05.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 04/29/2019] [Accepted: 05/01/2019] [Indexed: 11/17/2022]
Abstract
BACKGROUND While methadone maintenance therapy (MMT) in patients with opioid use disorder (OUD) decreases the risk of substance use relapses and criminal and risky sexual behavior, a major disadvantage is its negative impact on sexual function. In the present study we tested whether, compared to placebo, ginseng extract ameliorates methadone-related sexual dysfunction among female and male patients with OUD and receiving MMT. METHOD A total of 74 patients (26 females: mean age: M = 39.0 years; 48 males; mean age: 40.64 years) took part in a double-blind, randomized and placebo-controlled study. Female and male patients were separately randomly assigned either to the ginseng or to a placebo condition. At the beginning of the study and four weeks later, patients completed questionnaires on sexual function. RESULTS Irrespective of gender, sexual function improved over time, but more so in the ginseng condition than in the placebo condition. CONCLUSIONS Ginseng appears to counteract the sexual dysfunction resulting from methadone use in both female and male patients with OUD and undergoing MMT.
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Affiliation(s)
- Vahid Farnia
- Psychiatry Department, Substance Abuse Prevention Research Center, Health institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mostafa Alikhani
- Psychiatry Department, Substance Abuse Prevention Research Center, Health institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Alireza Ebrahimi
- Psychiatry Department, Substance Abuse Prevention Research Center, Health institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sanobar Golshani
- Psychiatry Department, Substance Abuse Prevention Research Center, Health institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Dena Sadeghi Bahmani
- Psychiatry Department, Substance Abuse Prevention Research Center, Health institute, Kermanshah University of Medical Sciences, Kermanshah, Iran; Isfahan Neurosciences Research Center, Alzahra Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran; Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran; University of Basel, Psychiatric Clinics (UPK), Center of Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland
| | - Serge Brand
- Psychiatry Department, Substance Abuse Prevention Research Center, Health institute, Kermanshah University of Medical Sciences, Kermanshah, Iran; Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran; University of Basel, Psychiatric Clinics (UPK), Center of Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland; University of Basel, Department of Sport, Exercise, and Health, Division of Sport Science and Psychosocial Health, Basel, Switzerland.
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10
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Farnia V, Tatari F, Alikhani M, Yazdchi K, Taghizadeh M, Sadeghi Bahmani D, Karbasizadeh H, Holsboer-Trachsler E, Brand S. Rosa Damascena oil improved methadone-related sexual dysfunction in females with opioid use disorder under methadone maintenance therapy - results from a double-blind, randomized, and placebo-controlled trial. J Psychiatr Res 2017; 95:260-268. [PMID: 28923720 DOI: 10.1016/j.jpsychires.2017.08.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Revised: 08/13/2017] [Accepted: 08/14/2017] [Indexed: 11/24/2022]
Abstract
BACKGROUND Methadone maintenance therapy (MMT) is provided to patients with opioid use disorder (OUD). However, as with all opioids, methadone impacts negatively on sexual function. To counter this, Rosa Damascena oil (RDO) has been used successfully for opioid-dependent male patients under MMT and with methadone-related sexual dysfunction (MRSD). In the present study, we tested the possible influence of RDO on sexual function and sex hormones of opioid-dependent female patients undergoing MMT and with MRSD. METHODS Fifty female patients (mean age: 38.8 years) diagnosed with OUD, undergoing MMT and with MRSD were randomly assigned either to the RDO or the placebo condition. At baseline, patients completed questionnaires covering socio-demographic and OUD-related information. At baseline, and four and eight weeks later they additionally completed questionnaires on sexual function and happiness. Blood samples to assess thyroid hormones, prolactin, progesterone, and estradiol levels were taken at baseline and eight weeks later (end of the study). RESULTS Over time sexual function and happiness increased, but more so in the RDO condition than in the placebo condition. Over time, prolactin decreased, and progesterone, and estradiol increased, but again more so in the RDO condition. Sex hormone levels and sexual function were statistically unrelated. CONCLUSIONS Results from this double-blind, randomized, and placebo-controlled clinical trial showed that opioid-dependent females undergoing MMT and with MRDS did benefit from RDO administration, as sexual function and happiness increased, and female sexual hormone levels changed in positive directions.
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Affiliation(s)
- Vahid Farnia
- Substance Abuse Prevention Research Center, Psychiatry Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Faeze Tatari
- Substance Abuse Prevention Research Center, Psychiatry Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mostafa Alikhani
- Substance Abuse Prevention Research Center, Psychiatry Department, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Katayoun Yazdchi
- Kermanshah University of Medical Sciences, Gynecology and Obstetrics Department, Kermanshah, Iran
| | - Moshen Taghizadeh
- Research Center for Biochemistry & Nutrition in Metabolic Diseases, Kashan University of Medical Sciences, Kashan, Iran
| | - Dena Sadeghi Bahmani
- University of Basel, Psychiatric Clinic (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland
| | | | - Edith Holsboer-Trachsler
- University of Basel, Psychiatric Clinic (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland
| | - Serge Brand
- Substance Abuse Prevention Research Center, Psychiatry Department, Kermanshah University of Medical Sciences, Kermanshah, Iran; University of Basel, Psychiatric Clinic (UPK), Center for Affective, Stress and Sleep Disorders (ZASS), Basel, Switzerland; University of Basel, Department of Sport, Exercise and Health, Division of Sport and Psychosocial Health, Basel, Switzerland.
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Abstract
BACKGROUND AND OBJECTIVE Cognitive impairment is one of the consequences of substance abuse. Tramadol abuse is a public health problem in Egypt. The objective of this study was to estimate the prevalence and correlates of cognitive impairment among tramadol-abuse patients and control subjects. METHODS This study included 100 patients with tramadol abuse and 100 control subjects (matched for age, sex, and education) who were recruited from Zagazig University Hospital, Egypt. Patients were divided into 2 groups: patients who used tramadol only (tramadol-alone group) and patients who used tramadol and other substances (polysubstance group). The participants were interviewed using Montreal Cognitive Assessment test and had urine screening for drugs. RESULTS Twenty-four percent of the cases used tramadol alone, whereas the remaining used tramadol and other substances, mainly cannabis (66%) and benzodiazepines (27%). Tramadol-abuse patients were about 3 times more likely to have cognitive impairment than control subjects (81% vs 28%). Tramadol-alone patients were more than 2 times more likely to have cognitive impairment than control subjects (67% vs 28%). Cognitive impairment was significantly associated with polysubstance abuse. There was no association between cognitive impairment and sociodemographic or clinical factors. CONCLUSIONS Cognitive impairment occurs commonly among tramadol-abuse patients. Memory impairment is the most common cognitive domain to be affected. There is a significant association between cognitive impairment and polysubstance abuse.
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12
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Clinical factors associated with sexual dysfunction among men in methadone maintenance treatment and buprenorphine maintenance treatment: a meta-analysis study. Int J Impot Res 2014; 26:161-6. [DOI: 10.1038/ijir.2014.18] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2013] [Revised: 04/14/2014] [Accepted: 05/12/2014] [Indexed: 01/23/2023]
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Metadonowa terapia substytucyjna w opinii pacjentów programu metadonowego z województwa łódzkiego – skuteczność, korzyści, problemy. ALCOHOLISM AND DRUG ADDICTION 2014. [DOI: 10.1016/s0867-4361(14)70004-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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14
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Yee A, Loh HS, Hisham Hashim HMB, Ng CG. The prevalence of sexual dysfunction among male patients on methadone and buprenorphine treatments: a meta-analysis study. J Sex Med 2013; 11:22-32. [PMID: 24344738 DOI: 10.1111/jsm.12352] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION For many years, methadone has been recognized as an effective maintenance treatment for opioid dependence. However, of the many adverse events reported, sexual dysfunction is one of the most common side effects. AIM We conducted a meta-analysis to evaluate the prevalence of sexual dysfunction among male patients on methadone and buprenorphine treatments. METHODS Relevant studies published from inception until December 2012 were identified by searching PubMed, OVID, and Embase. Studies were selected using prior defined criteria. Heterogeneity, publication bias, and odds ratio were assessed thoroughly. MAIN OUTCOME MEASURES To examine the prevalence and odds ratio of sexual dysfunctions among the methadone and buprenorphine groups. RESULTS A total of 1,570 participants from 16 eligible studies were identified in this meta-analysis. The studies provided prevalence estimates for sexual dysfunction among methadone users with a meta-analytical pooled prevalence of 52% (95% confidence interval [CI], 0.39-0.65). Only four studies compared sexual dysfunction between the two groups, with a significantly higher combined odds ratio in the methadone group (OR = 4.01, 95% CI, 1.52-10.55, P = 0.0049). CONCLUSIONS Evidence showed that the prevalence of sexual dysfunction was higher among the users of methadone compared with buprenorphine. Patients with sexual difficulty while on methadone treatment were advised to switch to buprenorphine.
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Affiliation(s)
- Anne Yee
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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