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The effects of Buprenorphine/Naloxane maintenance treatment on the quality of life, substance use and functionality in opiate dependence: a follow-up study Objective: Abstinance is not the only goal of the current drug addiction treatment modalities. New modalities focus rather on improvement in physical and mental health, personal and social functionality. It has been found that opioid maintanence treatment reduces the rates of illicit drug use, crime and sexual transmitted diseases in addition to increasing psychiatric, somatic and social functionality. In this study, we examined the effects of Buprenorphine/Naloxane (BN) maintenance treatment on substance abuse, quality of life and functionality. Method: The sample contained 50 opiate-dependent individuals who were hospitalized at the inpatient psychiatric unit for opioid detoxification and then followed at the addiction outpatient clinic of Istanbul University, Faculty of Medicine after their discharge from the hospital. The first interview was conducted at the inpatient unit and other interviews were conducted at the addiction outpatient clinic. The Addiction Severity Index and The Short-Form 36 were administrated to the patients at first interview, and then at the end of the third and sixth months while Visual Analog Scale and Perceived Stress Scale were administrated once a month. Results: Nineteen patients completed six month treatment period. However, all patients have been evaluated by using the last observation carried forward (LOCF) method in order to objectively measure the effect of treatment. Opioid maintenance treatment provided statistically significant decreases in opiate and non-opiate substance abuse, stress level and craving and there was significant improvement in all domains of SF-36 between baseline, 3 th and 6 th months. Significant improvements were found in employment, drug use, alcohol use, legal status, family/social status and psychiatric status which were assessed with ASI while there was no improvement in medical status. Significant improvements were recorded during the first three months and these improvements were maintained at the end of sixth month. Conclusion: BN maintenance therapy is potentially effective in ameliorating some of the adverse effects of opioid dependence on quality of life and functionality while reducing the rate of substance use.

ÖzetUygun doz ve sürede antidepresan tedaviye rağmen depresif hastaların yaklaşık %50-60'ında yeterli tedavi cevabı sağlanırken, sadece %35-40'ında remisyona ulaşılır. Psikostimulanlar depresyon tedavisinde rezidüel belirtilerin iyileştirilmesi ve tedavi cevabını hızlandırmak için aday ilaçlardandır. Klinisyenler günümüzde onaydışı olarak psikotimulanların ve alternatiflerini depresyonda güçlendirici tedavi olarak kullanmaktadırlar. Bu yazıda psikostimulan ajanların bipolar ve unipolar depresyonda etkinliği gözden geçirilmiştir. AbstractDespite antidepressant therapy of appropriate trial duration and dose optimization, 50-60% of depressed patients have an adequate treatment response, whereas only 35-40% achieve remission. Psychostimulants have been suggested as potential candidates to promote acceleration of response and to alleviate residual symptoms of depression. Nowadays, clinicians often consider the off-label use of stimulants or stimulant alternatives as adjunctive antidepressants. In this review study, we reviewed the available literature on the efficacy of these agents for treatment of refractory unipolar and bipolar depression.