Antidepressants During Office-based Buprenorphine

基于办公室的丁丙诺啡期间的抗抑郁药

• 批准号: 7292690
• 负责人: Michael D Stein
• 金额: $ 35.24万
• 依托单位: RHODE ISLAND HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-25 至 2009-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7292690
• 关键词: Adoption; Affect; Antidepressive Agents; Attenuated; Behavior; Buprenorphine; Caring; Chronic; Clinical; Combination Medication; Condition; Disease; Dropout; Drops; Effectiveness of Interventions; Escitalopram; Etiology; Evaluation; Evaluation Studies; Individual; Intervention; Mediating; Medical; Moods; Naloxone; Opiate Addiction; Opioid; Patients; Pharmaceutical Preparations; Pharmacological Treatment; Pharmacotherapy; Placebos; Positioning Attribute; Primary Health Care; Randomized; Recovery; Relapse; Score; Selective Serotonin Reuptake Inhibitor; Substance-Related Disorders; Theoretical model; Time; Treatment outcome; Withdrawal; base; craving; depressive symptoms; double-blind placebo controlled trial; improved; prevent

DESCRIPTION (provided by applicant): Opioid dependence is a chronic, relapsing medical disorder that affects an individual's mood and behavior. Treatment of opioid dependence using pharmacologic interventions to prevent withdrawal, relieve cravings and block or attenuate the euphoric effects of opioids has recently been enhanced with the adoption of buprenorphine/naloxone in primary care office-based medical practices. This proposal will study whether pharmacological treatment of depressive symptoms with selective serotonin reuptake inhibitors (SSRI) at the time of buprenorphine initiation for opioid dependence increases treatment retention among patients treated in office-based settings. The Primary Aims of this proposal are: 1) To perform a randomized, double blind, placebo-controlled trial to determine whether escitalopram treatment of depressive symptoms increases treatment retention among opioid dependent 182 patients initiating office-based buprenorphine treatment. 2) To determine if antidepressant medication treatment reduces depressive symptom scores compared to a placebo condition among office-based buprenorphine treatment recipients. Our theoretical model postulates that an intervention effect on depressive symptoms should mediate buprenorphine treatment dropout. We propose that pharmacotherapy will improve depressive symptoms commonly seen at the time of and after the initiation of buprenorphine therapy and thereby improve the stability of recovery. Our results will have immediate clinical implications for the care of buprenorphine patients receiving office-based opioid dependence treatment. The focus of this study, the evaluation of combinations of medications, to treat substance-related disorders, fits squarely within the emphasis of this RFA.

描述（由申请人提供）：阿片类药物依赖是一种慢性、复发性的疾病，会影响个人的情绪和行为。最近，随着初级保健办公室医疗实践中丁丙诺啡/纳洛酮的采用，使用药物干预措施来预防戒断、缓解渴望以及阻止或减弱阿片类药物的欣快作用的阿片类药物依赖性治疗得到了加强。该提案将研究在因阿片类药物依赖而开始使用丁丙诺啡时，使用选择性血清素再摄取抑制剂（SSRI）对抑郁症状进行药物治疗是否可以增加在办公室接受治疗的患者的治疗保留率。该提案的主要目标是： 1) 进行一项随机、双盲、安慰剂对照试验，以确定艾司西酞普兰治疗抑郁症状是否可以提高 182 名阿片类药物依赖患者开始就诊丁丙诺啡治疗的治疗保留率。 2) 确定在办公室丁丙诺啡治疗接受者中，与安慰剂相比，抗抑郁药物治疗是否可以降低抑郁症状评分。我们的理论模型假设对抑郁症状的干预作用应该介导丁丙诺啡治疗的退出。我们建议药物治疗将改善丁丙诺啡治疗开始时和治疗后常见的抑郁症状，从而提高康复的稳定性。我们的结果将对接受基于办公室的阿片类药物依赖治疗的丁丙诺啡患者的护理产生直接的临床影响。这项研究的重点是评估治疗物质相关疾病的药物组合，这完全符合本次 RFA 的重点。