Faculty of Medicine
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Item type:Publication, The Effect of Buprenorphine therapy on depressive symptomatology in heroin addicts(Scientific Institute of Management and Knowledge, 2025-04-16); Danijela Janichevikj, IvanovskaAbstract: According to the World Health Organization, heroin addiction is one of the most widespread diseases, right behind cardiovascular and malignant diseases. Heroin addicts have a large number of comorbid somatic and psychological disorders, among which depressive states occupy a significant place. It is known that on the territory of North Macedonia, two substitutes are used in the treatment of heroin addiction: methadone, which is an opioid agonist, and buprenorphine, which is an opioid agonist and antagonist. Of particular importance is the effect of buprenorphine on kappa receptors, which have a major impact on mood and sexual functioning. So the goal of this research is to see the effectiveness of buprenorphine therapy on depression in heroin addicts. Materials and methods: In this prospective study, which was conducted at the Day Hospital for Addictions at the Psychiatric Hospital Skopje, 20 heroin addicts undergoing treatment with buprenorphine therapy were evaluated before treatment after three months and after six months of treatment. The study used a questionnaire to collect sociodemographic data (gender, age, education, marital status, employment) specifically designed for the study. Depression scores were determined using the Hamilton Depression Rating Scale. Data were analyzed by descriptive method and by Student's t test. Statistical significance was considered p< 0.05. According to the data obtained, after three months of treatment with buprenorphine we had a decrease the score of depression but without statistical significance p= 0,43, while after six month of treatment we had a decrease with statistical significance p=0,034. However, in 5% of the respondents the score of depression was still high. Conclusion The results obtained in our study indicated that buprenorphine therapy affects the reduction of depressive symptomatology in heroin addicts. So, when we have a high depression score in patients, antidepressants should not be used immediately, but buprenorphine should be allowed to take effect first. If there is no improvement, then move on to the second step, including antidepressant therapy. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, COMPARATION BETWEEN METHADONE AND BUPRENIRFINE THERAPY(SHMSHM/AAMD, 2022-09-02)Heroin dependence is a major health and social problem associated with increased morbidity and mortality that adversely affects social circumstances, productivity, healthcare and law enforcement cost. Methadone and buprenorphine are the major modalities of the opioid substitution therapy. (OST) for opioid dependence in North Macedonia. Also some researchers reported that illicit heroin use is an international problem. Opiate use or dependence is destructive in many levels, it is associated with higher rates of hepatitis C and HIV infection, overdose and criminality. Buprenorphine and methadone each have specific advantages and disadvantages. Properly and judiciously used, either can help suitably selected patients avoid illicit opioid use while improving mental health and quality of life. The AIM pf this study is to compare the efficiency between methadone and buprenorphine therapy. MATERIJALS AND METHODS.The cross section present study included two groups of male patients: on methadone (n=50) and patients on buprenorphine therapy (n=50) , between 20-51 years, evaluated in Day hospital of heroin addicts- department of Psychiatric Hospital Skopje with diagnosis of opiate addictions F11.2 The study was conducted for 6 month. All the patients was written informed consent. The patients were assess using the sociodemographic information by semi-structured questionnaire specially designed for the study. The sociodemographic data was: age, marital status, education status and employment. Urinary tests for determination of psychoactive substances. Blood test for hepatitis C detection. The sexual function in man was assess by Questionnaire International Index of Erectile Function (IIEF-scale). The results of this study were determinate by descriptive methods, t-test for independent simplex .and Pearson coefficient correlation. P<0.05 was considered statistically significant. RESULTS: In our study we got that the level of education (p=0, 05); marital status (p=0, 07); employment (p=0, 08) was higher in patients with buprenorphine therapy but without statistical significantly. Also the recidivism of heroin use (p=0, 02), benzodiazepine (p=0, 03) and cocaine use (p=0, 05) was statistically significant higher in patients with buprenorphine therapy, but retention on treatment was higher in methadone maintenance patients without statistically significant. When compare correlation between score of sexual dysfunction and dose of methadone and buprenorphine therapy we got positive correlation , but is was higher and with statistically significant in patients with methadone therapy than patients with buprenorphine therapy Also we got higher percentage of sexual dysfunction in methadone maintenance patients 65,3/34,7% than buprenorphine therapy.35.8/64,2 The results in this study reported no differences between patients with hepatitis C on substitution treatment p=0, 72 CONCLUSION: Results in our studies, suggested that buprenorphine therapy improves the quality of patients’ social development while methadone therapy diminished heroin recidivism. This knowledge creates an opportunity for doctors to convert OST therapy depending on the need.