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Heroin Addiction and Related Clinical Problems: 2024, 26, 7

Psychometric evaluation of two patients monitored for 12 weeks after switching from racemic methadone to levomethadone agonist therapy

Gabriele Pasquale De Luca, Gaia Anibaldi, Danilo Paolucci, Paola Motta, and Simone De Persis

Digital Object Identifier:
https://doi.org/10.62401/2531-4122-2024-7

Summary: Background. Opioid agonist therapy (OAT) is a crucial tool for leading drug-dependent patients to abstinence from substances. Among the currently available treatment options, levomethadone appears to demonstrate excellent therapeutic potential in the long term. Yet, much can still be learned from levomethadone application in complex clinical cases. This article describes two clinical cases of patients with severe opioid dependence and psychiatric comorbidities who switched from racemic methadone to levomethadone. Methods. We present a description of the therapeutical history of these two patients and report the outcomes of various psychometric tests (i.e., HAM-D, HAM-A, BPRS, GAF, OOWS, SOWS, OC-VAS, SF-36, SDS, CGI) performed at the beginning of levomethadone therapy, four weeks later, and 12 weeks later. Results. Both patients have complex treatment histories characterised by successes and failures from previous therapies. At the time of initiation of levomethadone therapy, the clinical status of both patients was characterised by a high degree of psychopathological symptoms, distress, substance abuse, and poor levels of functioning. The re-evaluation of patients after 4 and 12 weeks of treatment with levomethadone showed a significant improvement in all psychometric tests administered. Conclusions. The transition from racemic methadone to levomethadone appears to occur smoothly without any particular psychophysical relapses. The data from these two complex cases confirm the long-term therapeutical benefit of levomethadone.

Keywords: opioid use disorder; opioid agonist therapy; racemic methadone; levomethadone; psychometric scales