Association of CYP2D6 ultrarapid metabolizer genotype with deficient patient satisfaction regarding methadone maintenance treatment

• Published in: Drug and alcohol dependence 2007-07, Vol.89 (2), p.190-194
• Main Authors: Pérez de los Cobos, José, Siñol, Núria, Trujols, Joan, del Río, Elisabeth, Bañuls, Enrique, Luquero, Elena, Menoyo, Anna, Queraltó, Josep Maria, Baiget, Montserrat, Álvarez, Enric
• Format: Article
• Language: English
• Subjects: Addictive behaviors; Adult; Adult and adolescent clinical studies; Biological and medical sciences; Cytochrome P-450 CYP2D6; Cytochrome P-450 CYP2D6 - genetics; Drug addiction; Drug dependency; Female; Gene Frequency - genetics; Genetics; Genotype; Heroin; Heroin dependence; Heroin Dependence - blood; Heroin Dependence - genetics; Heroin Dependence - psychology; Heroin Dependence - rehabilitation; Humans; Male; Medical sciences; Metabolic Clearance Rate - genetics; Metabolic Clearance Rate - physiology; Methadone; Methadone - pharmacokinetics; Methadone - therapeutic use; Methadone maintenance treatment; Middle Aged; Narcotics - pharmacokinetics; Narcotics - therapeutic use; Patient Satisfaction; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Satisfaction; Satisfaction with treatment; Sex Factors; Street Drugs; Substance Abuse Detection; Substance-Related Disorders - diagnosis; Substance-Related Disorders - genetics; Substance-Related Disorders - psychology; Toxicology; Treatment; Treatment Refusal - psychology
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2006.12.018

Abstract Objective The activity of cytochrome P-450 enzyme 2D6 (CYP2D6) could be related to heroin-dependent patient satisfaction with methadone maintenance treatment. We sought to compare satisfaction with the usual methadone treatment in patients who are ultrarapid, extensive or poor metabolizers, according to CYP2D6 genotyping. Methods Two hundred and five heroin-dependent patients filled out the Verona Service Satisfaction Scale for methadone maintenance treatment (VSSS-MT), before CYP2D6 genotyping. Results VSSS-MT overall scores were comparable in the poor metabolizer ( N = 9) and extensive metabolizer ( N = 185) groups, although they were higher in poor metabolizers and extensive metabolizers taken together than in the ultrarapid metabolizers ( N = 11) ( p < 0.003). Likewise, ultrarapid metabolizers scored higher than the rest of the sample on the VSSS-MT Basic Interventions subscale ( p < 001). Regarding this subscale, no poor metabolizers felt dissatisfied, and ultrarapid metabolizer males ( N = 7) reported lower satisfaction than ultrarapid metabolizer females ( N = 4) ( p < 0.022). Ultrarapid metabolizer genotype accounted for 4.2% of the variance on the VSSS-MT total scores, and 5.0% on the Basic Intervention scores. Conclusion Heroin-dependent patients who are CYP2D6 ultrarapid metabolizers according to genotyping present deficient satisfaction with methadone maintenance treatment.