Cardiac autonomic modulation during methadone therapy among heroin users

A pilot study

Li Ren Chang, Yu Hsuan Lin, Terry B J Kuo, Yen Cheng Ho, Shiuan Horng Chen, Hung Chieh Wu Chang, Chih Min Liu, Cheryl C H Yang

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: Methadone therapy benefits heroin users in both the medical and psychosocial dimensions. However, both heroin and methadone have cardiac toxicity. Only limited information is available describing the changes in cardiac autonomic function of heroin users and effects of methadone therapy. We conduct the current study to explore the cardiac vagal function in heroin users as well as the impact of lapse and methadone therapy. Methods: 80 heroin users from a methadone therapy clinic were distributed into 31 compliant and 49 incompliant patients according to whether they lapsed into heroin use within 10. days. 40 healthy control subjects were recruited from the community. Participants underwent electrocardiographic recordings and the heroin users were further investigated before and after methadone therapy. Spectral analysis of heart rate variability (HRV) was computed for cardiac parasympathetic modulation (high-frequency power, HF) and cardiac sympathetic modulation (normalized low-frequency power, LF%). Results: The baseline HRV parameters found lower HF values for heroin users and lower RR interval values for patients with a recent lapse compared with the healthy control subjects. After 1. h of methadone administration, heroin users who had lapsed showed a significant increase in HF but the heroin users who had not lapsed did not. Conclusion: Our findings suggest that heroin users show decreased cardiac vagal activity and that methadone therapy immediately facilitates vagal regulation in patients with a recent lapse. The differential patterns of autonomic alteration under methadone between those with and without lapse might offer an objective measure of lapse.

Original languageEnglish
Pages (from-to)188-193
Number of pages6
JournalProgress in Neuro-Psychopharmacology and Biological Psychiatry
Volume37
Issue number1
DOIs
Publication statusPublished - Apr 27 2012
Externally publishedYes

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Methadone
Heroin
Therapeutics
Healthy Volunteers
Heart Rate

Keywords

  • Autonomic nervous system
  • Heart rate variability
  • Heroin
  • Methadone
  • Opioid

ASJC Scopus subject areas

  • Biological Psychiatry
  • Pharmacology

Cite this

Cardiac autonomic modulation during methadone therapy among heroin users : A pilot study. / Chang, Li Ren; Lin, Yu Hsuan; Kuo, Terry B J; Ho, Yen Cheng; Chen, Shiuan Horng; Wu Chang, Hung Chieh; Liu, Chih Min; Yang, Cheryl C H.

In: Progress in Neuro-Psychopharmacology and Biological Psychiatry, Vol. 37, No. 1, 27.04.2012, p. 188-193.

Research output: Contribution to journalArticle

Chang, Li Ren ; Lin, Yu Hsuan ; Kuo, Terry B J ; Ho, Yen Cheng ; Chen, Shiuan Horng ; Wu Chang, Hung Chieh ; Liu, Chih Min ; Yang, Cheryl C H. / Cardiac autonomic modulation during methadone therapy among heroin users : A pilot study. In: Progress in Neuro-Psychopharmacology and Biological Psychiatry. 2012 ; Vol. 37, No. 1. pp. 188-193.
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AB - Background: Methadone therapy benefits heroin users in both the medical and psychosocial dimensions. However, both heroin and methadone have cardiac toxicity. Only limited information is available describing the changes in cardiac autonomic function of heroin users and effects of methadone therapy. We conduct the current study to explore the cardiac vagal function in heroin users as well as the impact of lapse and methadone therapy. Methods: 80 heroin users from a methadone therapy clinic were distributed into 31 compliant and 49 incompliant patients according to whether they lapsed into heroin use within 10. days. 40 healthy control subjects were recruited from the community. Participants underwent electrocardiographic recordings and the heroin users were further investigated before and after methadone therapy. Spectral analysis of heart rate variability (HRV) was computed for cardiac parasympathetic modulation (high-frequency power, HF) and cardiac sympathetic modulation (normalized low-frequency power, LF%). Results: The baseline HRV parameters found lower HF values for heroin users and lower RR interval values for patients with a recent lapse compared with the healthy control subjects. After 1. h of methadone administration, heroin users who had lapsed showed a significant increase in HF but the heroin users who had not lapsed did not. Conclusion: Our findings suggest that heroin users show decreased cardiac vagal activity and that methadone therapy immediately facilitates vagal regulation in patients with a recent lapse. The differential patterns of autonomic alteration under methadone between those with and without lapse might offer an objective measure of lapse.

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