A Pilot Crossover Trial of Sleep Medications for Sleep-disturbed Methadone Maintenance Patients. Issue 2 (March 2020)

• Record Type: Journal Article
• Authors: Stein, Michael D.; Kurth, Megan E.; Anderson, Bradley J.; Blevins, Claire E.
• Is Part Of: Journal of addiction medicine. Volume 14:Issue 2(2020)
• Publication Date: 2020-03
• Subjects: actigraphy -- opiate use disorder -- psychopharmacology; Substance abuse -- Periodicals; Substance abuse -- Treatment -- Periodicals; Substance-Related Disorders -- Periodicals; 616.86005
• DOI: 10.1097/ADM.0000000000000531
• Languages: English
• ISSNs: 1932-0620

Abstract

Abstract : Objectives: Problems with sleep are a common and detrimental occurrence among individuals who receive methadone maintenance for opioid use disorder (OUD). Methods: We enrolled ten methadone-maintained persons with insomnia (60% female, mean age 40) in a double-blind trial using actigraphy to confirm daily sleep reports. After a no-medication week to establish baseline sleep patterns, each participant received 1 week each of mirtazapine (30 mg), zolpidem (sustained-release 12.5 mg), mirtazapine (30 mg IR) plus zolpidem (10 mg), and placebo, with a washout week between each medication week. Study medication order was randomized so that the order of each 1-week medication treatment was different for each participant, but all participants received all 4 regimens. Results: We found that mirtazapine alone improved total sleep (mean 23 minutes), sleep latency (mean 23 minutes), and sleep efficiency (mean 3%), surpassing the other regiments. Conclusions: This pilot work suggests that mirtazapine is worthy of further testing as a sleep aid for persons with OUD receiving methadone maintenance.