Impact of opioid agonist treatment on mental health in patients with opioid use disorder: A systematic review and network meta-analysis of randomized clinical trials.
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Impact of opioid agonist treatment on mental health in patients with opioid use disorder: A systematic review and network meta-analysis of randomized clinical trials. / Moazen-Zadeh, Ehsan; Ziafat, Kimia; Yazdani, Kiana; Kamel, Mostafa M; Wong, James S H; Modabbernia, Amirhossein; Blanken, Peter; Verthein, Uwe; Schütz, Christian G; Jang, Kerry; Akhondzadeh, Shahin; Krausz, R Michael.
in: AM J DRUG ALCOHOL AB, Jahrgang 47, Nr. 3, 04.05.2021, S. 280-304.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
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TY - JOUR
T1 - Impact of opioid agonist treatment on mental health in patients with opioid use disorder: A systematic review and network meta-analysis of randomized clinical trials.
AU - Moazen-Zadeh, Ehsan
AU - Ziafat, Kimia
AU - Yazdani, Kiana
AU - Kamel, Mostafa M
AU - Wong, James S H
AU - Modabbernia, Amirhossein
AU - Blanken, Peter
AU - Verthein, Uwe
AU - Schütz, Christian G
AU - Jang, Kerry
AU - Akhondzadeh, Shahin
AU - Krausz, R Michael
PY - 2021/5/4
Y1 - 2021/5/4
N2 - Background: There is a knowledge gap in systematic reviews on the impact of opioid agonist treatments on mental health.Objectives: We compared mental health outcomes between different opioid agonist treatments and placebo/waitlist, and between the different opioids themselves.Methods: This meta-analysis of randomized clinical trials (RCTs) was pre-registered at PROSPERO (CRD42018109375). Embase, MEDLINE, PsychInfo, CINAHL Complete, and Web of Science Core Collection were searched from inception to May 2020. RCTs were included if they compared opioid agonists with each other or with placebo/waitlist in the treatment of patients with opioid use disorder and reported at least one mental health outcome after 1-month post-baseline. Studies with psychiatric care, adjunct psychotropic medications, or unbalanced psychosocial services were excluded. The primary outcome was overall mental health symptomatology, e.g. Symptom Checklist 90 total score, between opioids and placebo/waitlist. Random effects models were used for all the meta-analyses.Results: Nineteen studies were included in the narrative synthesis and 15 in the quantitative synthesis. Hydromorphone, diacetylmorphine (DAM), methadone, slow-release oral morphine, buprenorphine, and placebo/waitlist were among the included interventions. Based on the network meta-analysis for primary outcomes, buprenorphine (SMD (CI95%) = -0.61 (-1.20, -0.11)), DAM (-1.40 (-2.70, -0.23)), and methadone (-1.20 (-2.30, -0.11)) were superior to waitlist/placebo on overall mental health. Further direct pairwise meta-analysis indicated that overall mental health improved more in DAM compared to methadone (-0.23 (-0.34, -0.13)).Conclusions: Opioid agonist treatments used for the treatment of opioid use disorder improve mental health independent of psychosocial services.
AB - Background: There is a knowledge gap in systematic reviews on the impact of opioid agonist treatments on mental health.Objectives: We compared mental health outcomes between different opioid agonist treatments and placebo/waitlist, and between the different opioids themselves.Methods: This meta-analysis of randomized clinical trials (RCTs) was pre-registered at PROSPERO (CRD42018109375). Embase, MEDLINE, PsychInfo, CINAHL Complete, and Web of Science Core Collection were searched from inception to May 2020. RCTs were included if they compared opioid agonists with each other or with placebo/waitlist in the treatment of patients with opioid use disorder and reported at least one mental health outcome after 1-month post-baseline. Studies with psychiatric care, adjunct psychotropic medications, or unbalanced psychosocial services were excluded. The primary outcome was overall mental health symptomatology, e.g. Symptom Checklist 90 total score, between opioids and placebo/waitlist. Random effects models were used for all the meta-analyses.Results: Nineteen studies were included in the narrative synthesis and 15 in the quantitative synthesis. Hydromorphone, diacetylmorphine (DAM), methadone, slow-release oral morphine, buprenorphine, and placebo/waitlist were among the included interventions. Based on the network meta-analysis for primary outcomes, buprenorphine (SMD (CI95%) = -0.61 (-1.20, -0.11)), DAM (-1.40 (-2.70, -0.23)), and methadone (-1.20 (-2.30, -0.11)) were superior to waitlist/placebo on overall mental health. Further direct pairwise meta-analysis indicated that overall mental health improved more in DAM compared to methadone (-0.23 (-0.34, -0.13)).Conclusions: Opioid agonist treatments used for the treatment of opioid use disorder improve mental health independent of psychosocial services.
KW - Analgesics, Opioid/therapeutic use
KW - Buprenorphine/therapeutic use
KW - Heroin/therapeutic use
KW - Humans
KW - Mental Disorders/drug therapy
KW - Mental Health
KW - Methadone/therapeutic use
KW - Network Meta-Analysis
KW - Opiate Substitution Treatment
KW - Opioid-Related Disorders/drug therapy
KW - Psychotherapy
KW - Randomized Controlled Trials as Topic
U2 - 10.1080/00952990.2021.1887202
DO - 10.1080/00952990.2021.1887202
M3 - SCORING: Review article
C2 - 33780647
VL - 47
SP - 280
EP - 304
JO - AM J DRUG ALCOHOL AB
JF - AM J DRUG ALCOHOL AB
SN - 0095-2990
IS - 3
ER -
