Author(s): Mehak Pahwa, BS Sidhu, Rajnish Raj and Eish Kumar
Background: Tramadol is an atypical centrally acting synthetic analgesic and its o-demethylated metabolite, (+)-o-demethyltramadol (known as m1), has greater affinity for the mu-opioid receptor which makes it a candidate for opiate withdrawal treatment. , it appears to have low abuse potential and is a non-scheduled analgesic.
Aim and Objective: to compare the effects and relative clinical utility of Tramadol and Buprenorphine in the treatment of heroine withdrawal in opioid dependant patients.
Methods: Ina randomized open label parallel group design study, 70 patients with opioid dependence with daily heroine use equal to 1-10 mg, 10-20 mg, >20 mg methadone using stratified proportionate sampling were assigned into two treatment groups i.e. Tramadol and Buprenorphine. Flexible dosing schedule was followed and drug was titrated using (COWS) Clinical Opiate Withdrawal Scale and (CGI) Clinical Global Impression
Results: There was statistically significant difference between the two groups in patients with moderate level of addiction with 78% of Tramadol group and 57% of the Buprenorphine group completed detoxification at the end of 12 weeks. Whereas patients with severe level of addiction had to be maintained on buprenorphine and detoxification could not be completed with high dropout rate in tramadol group
Discussion: Tramadol has good efficacy in detoxification and relapse prevention in patients with moderate level of opioid dependence as compared to buprenorphine, Whereas Buprenorphine is better for maintenance treatment and is of higher clinical utility in severe level of opioid dependence where maintenance therapy is required.
