Objective:We aimed to compare the effectiveness of extended-release naltrexone (XR-NTX) implant and sublingual buprenorphine-naloxone (BUP-NX) in relapse prevention in opiate use disorder (OUD).Methods: Medical records of 400 patients who were treated for OUD between 2016 and 2020 were retrospectively evaluated concerning sociodemographic and clinical characteristics and abstinence duration with either BUP-NX (192 patients) or XR-NTX (208 patients) as maintenance treatments. Results:The median age of patients using BUP-NX was 25.00, and the median age of patients using XR-NTX was 25.50 (p = .785). The ratio of female patients in the BUP-NX group and the XR-NTX group was 7.3% (n = 14) and 6.7% (n = 14), respectively. A significantly higher abstinence time was observed in the BUP-NX group (median = 4 months) than in the XR-NTX group (median = 3 months) (p = .015). Liver function tests were within the normal ranges at the three time points, which were just before the beginning and in the first and third months of treatment.Conclusions: These findings suggest that BUP-NX might be more effective than XR-NTX in preventing relapse in OUD and both drugs are safe for the liver. Prospective randomized studies are needed to replicate our results.
Objective: This study aims to investigate the effects of repetitive transcranial magnetic stimulation (rTMS) treatment in a group of treatment-resistant obsessive-compulsive disorder (OCD) patients and to examine the relationship between various sociodemographic and clinical variables and treatment response. Materials and Methods: Data including The Yale–Brown Obsessive Compulsive Scale (Y-BOCS) scores and various clinical and sociodemographic characteristics of 27 treatment-resistant OCD patients who received 30 sessions of low-frequency rTMS (LF-rTMS) treatment on the left dorsolateral prefrontal cortex (DLPFC) were analyzed. Results: Mean Y-BOCS scores decreased significantly across week 0 and the 3rd week (t(26)=10.59, p<.001) and continued to decrease significantly across weeks 3 and 6 (t(26)=11.47, p<.001). 21(78%) patients were responders with at least a %25 decrease in the mean Y-BOCS scores, and 10(47.6%) of these 21 patients also met the complete response criteria with a 35% or more reduction in Y-BOCS. No significant difference was observed between responders and non-responders regarding various clinical and sociodemographic variables. The only reported side effects were headaches and local scalp tenderness, which improved in a short time. Conclusion: This descriptive study has demonstrated the efficacy of a long-duration LF-rTMS application on the DLPFC in a group of drug-resistant OCD patients. This finding might contribute to the available literature, especially in drawing out a standardized treatment protocol in these cases.
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