Methadone versus morphine for treatment of neonatal abstinence syndrome: A prospective randomized clinical trial

Objective: Compare duration of treatment of neonatal abstinence syndrome between methadone and morphine. Study design: A prospective, double-masked, randomized trial at a single site. Randomization of methadone or morphine was stratified for maternal treatment with methadone or buprenorphine. Inclus...

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Bibliographic Details
Published in:Journal of perinatology 2015-04, Vol.35 (4), p.278-283
Main Authors: Brown, M S, Hayes, M J, Thornton, L M
Format: Article
Language:English
Subjects:
692/308/409
Analgesics, Opioid - administration & dosage
Birth Weight
Buprenorphine
Buprenorphine - therapeutic use
Clinical trials
Comparative analysis
Diseases
Double-Blind Method
Drug therapy
Drug withdrawal
Drug withdrawal symptoms
Female
Gestational Age
Humans
Infant, Newborn
Infants
Infants (Newborn)
Length of Stay
Male
Medicine
Medicine & Public Health
Methadone
Methadone - administration & dosage
Methadone hydrochloride
Morphine
Morphine - administration & dosage
Narcotics
Neonatal abstinence syndrome
Neonatal Abstinence Syndrome - drug therapy
Neonates
Newborn babies
Opioids
original-article
Pediatric research
Pediatric Surgery
Pediatrics
Prospective Studies
Treatment Outcome
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Summary:Objective: Compare duration of treatment of neonatal abstinence syndrome between methadone and morphine. Study design: A prospective, double-masked, randomized trial at a single site. Randomization of methadone or morphine was stratified for maternal treatment with methadone or buprenorphine. Inclusion criteria were (i) maternal treatment with prescribed methadone or buprenorphine, (ii) withdrawal treatment criteria, (iii) adjusted gestational age ⩾35 0/7 weeks and (iv) medically stable. Primary outcome was length of opioid treatment. Result: From January 2011 through October 2012, 78 infants were eligible for the study: 41 methadone-exposed and 37 buprenorphine-exposed. Consent was obtained from 31 mothers, 13/41 (32%) methadone-treated and 18/37 (49%) buprenorphine-treated. Length of opioid treatment was significantly shorter for methadone than morphine treatment, median 14 versus 21 days ( P =0.008). Conclusion: Methadone had a shorter length of neonatal withdrawal treatment compared with morphine. Owing to the smaller sample size and single site, a larger randomized study is needed.
ISSN:0743-8346
1476-5543
DOI:10.1038/jp.2014.194