Introduction: Methadone and buprenorphine are among the most widely employed pharmacological treatments currently available for opioid addiction. Cognitive effects of buprenorphine in abstinent heroin abusers are nevertheless far from being understood. Methods: Neuropsychological performance of 18 buprenorphine-maintained patients (BMP) was evaluated relative to that of 32 currently abstinent heroin abusers on naltrexone hydrochloride therapy (FHAN), and 34 non-drug dependent controls. The three groups were demographically balanced. Clinical groups reported histories of similar patterns of drug use and had increased periods of abstinence from any illicit substance use including heroin. Results: The BMP group performed poorer than controls on the RAVLT (encoding and delayed recall of verbal information), CTT (conceptual flexibility, executive functions) and the RBANS figure copy (visual perception) and delayed recall of visual information. There were no significant differences in any of the cognitive measures between the BMP and FHAN groups or between the FHAN group and controls. Furthermore, there were no differences in the percentage of abnormal cases between the two patient groups. Conclusion: Overall, results suggest that treatment with naltrexone in abstinent heroin abusers may result in less impairment of cognitive functions compared to treatment with buprenorphine. These findings are relevant for improved prognosis and treatment strategies in opioid dependence.

Introduction: The issue of the association between depression and neurocognitive functions is of special interest due to the strong relation between primary depressive symptoms and cognitive impairments, but this relationship in PD is far from clear at present. Objectives: To examine the influence of depression on cognitive and speech performance in various stages of PD. Methods: Forty four patients with PD were recruited from the neurology department, University Hospital of Patras in Greece. All patients satisfied PDSBB criteria and dementia was ruled out (MMSE < 24) in all cases. Patients were then divided into six groups, based on severity of PD symptoms and presence of depression. Stage of disease severity was determined using the Hoehn-Yahr Rating Scale. Presence and severity of depression was established using the Beck Depression Inventory and DSM-IV-TR diagnostic criteria for major depressive disorder and dysthymia. Patients were further assessed with a detailed neuropsychological battery and the dysarthria examination battery. All patients were receiving standard medications for their PD symptoms. Results: Deficits in executive functions, prosody and speech intelligibility were most profound in the late stage depressed PD group. Phonetic impairments were most profound across all stages compared to articulatory and prosodic impairments. Conclusions: Depressed mood may exacerbate cognitive and speech impairments and affective variables should be an integral part in the treatment of PD in all stages of the disease process, but especially in the later stages.

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