Methadone maintenance treatment and St. John's Wort - a case report.

Détails

ID Serval
serval:BIB_33959DD0A326
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Etude de cas (case report): rapporte une observation et la commente brièvement.
Collection
Publications
Institution
Titre
Methadone maintenance treatment and St. John's Wort - a case report.
Périodique
Pharmacopsychiatry
Auteur(s)
Eich-Höchli D., Oppliger R., Golay K.P., Baumann P., Eap C.B.
ISSN
0176-3679
Statut éditorial
Publié
Date de publication
2003
Peer-reviewed
Oui
Volume
36
Numéro
1
Pages
35-7
Langue
anglais
Notes
Publication types: Case Reports ; Clinical Trial ; Letter ; Research Support, Non-U.S. Gov't - Publication Status: ppublish
Résumé
St. John's wort, a popular over-the-counter drug for treatment of depression, might reduce concentrations of drugs such as cyclosporin and indinavir and lead to drug resistance and treatment failure. No studies as yet have examined its influence on methadone plasma levels. The trough methadone plasma levels were measured in four patients (2 males, median age: 31 years; range 19 - 40 years) in methadone maintenance treatment just before the introduction of St. John's wort (900 mg/d) and after a median period of 31-day treatment (range 14 - 47). The study was proposed to addict patients about to start an antidepressant therapy. Introduction of St. John's wort resulted in a strong reduction of (R,S)-methadone concentration-to-dose ratios in the four median patients included, with a median decrease to 47 % of the original concentration (range: 19 % - 60 % of the original concentration). Two patients reported symptoms that suggested a withdrawal syndrome. Thus, prescription of St. John's wort might decrease methadone blood levels and induce withdrawal symptoms which, if not correctly identified and handled (by changing the antidepressant or by increasing the methadone dose), might cause unnecessary discomfort to the patient, lead to resumption of illicit drug uses, or be a risk factor for discontinuation of the methadone or antidepressant treatment.
Mots-clé
Adult, Analgesics, Opioid, Depressive Disorder, Drug Interactions, Drug Therapy, Combination, Humans, Hypericum, Male, Methadone, Plant Preparations, Substance-Related Disorders
Pubmed
Web of science
Création de la notice
10/03/2008 11:53
Dernière modification de la notice
20/08/2019 14:19
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