Abstract
BackgroundMethadone is an effective therapy for opiate dependence. However, one of the commonest side effects is sexual dysfunction among male patients. Buprenorphine is an alternative to methadone. This study aimed to compare sexual desire among opiate-dependent male patients on buprenorphine (BMT) and methadone maintenance therapy (MMT).MethodsThis cross-sectional study involved 126 male opiate-dependent patient who were tested for total testosterone (TT) and prolactin levels, and were interviewed and completed the Sexual Desire Inventory-2 (SDI-2), Malay language of International Index of Erectile Function (Mal-IIEF-15) and the Malay version of the self-rated Montgomery-Asberg Depression Rating Scale (MADRS-BM) questionnaires.ResultsThere were 95 (75.4%) patients on MMT and 31 (24.6%) on BMT. Patients on MMT scored significantly lower in the sexual desire domain (Mal-IIEF-15 scores) (p < 0.01), dyadic sexual desire (p = 0.04) and TT plasma level (p < 0.01) when compared to BMT group after controlling all the confounders.ConclusionsPatients on MMT are associated with lower sexual desire when compared with patients on BMT. Smoking may further lower testosterone and, hence, sexual desire in those already on methadone.
Highlights
Methadone is an effective therapy for opiate dependence
Four methadone maintenance therapy (MMT) patients and two Buprenorphine maintenance therapy (BMT) patients refused to participate in the study
The MMT arm consisted of 75.4% (n = 95) of the patients while the remaining 24.6% (n = 31) made up the BMT group
Summary
Methadone is an effective therapy for opiate dependence. one of the commonest side effects is sexual dysfunction among male patients. This study aimed to compare sexual desire among opiate-dependent male patients on buprenorphine (BMT) and methadone maintenance therapy (MMT). Since methadone maintenance treatment (MMT) is a well-recognized effective replacement therapy for opiate dependence [6], for many decades, clinicians have been using methadone with significant success in reducing cases of heroin use [7, 8], criminal activity [9,10,11], unemployment [10, 12], mortality [13,14,15,16] and the transmission of infectious diseases [11, 17, 18]. The physicians need other strategies to manage sexual dysfunction in this group of patients
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