Document Detail


Methadone and metabolites in hair of methadone-assisted pregnant women and their infants.
MedLine Citation:
PMID:  22495425     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Methadone is the recommended pharmacotherapy for opioid-dependent pregnant women. The primary aims of this study were to determine whether a dose-concentration relationship exists between cumulative maternal methadone dose, methadone and metabolite concentrations in maternal hair during pregnancy and whether maternal hair methadone and metabolite concentrations predict neonatal outcomes.
MATERIALS AND METHODS: Hair specimens were collected monthly from opioid-dependent mothers enrolled in methadone treatment and 4 of their infants. Hair specimens were segmented (3 cm), washed (maternal hair only), and analyzed for methadone, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP), and 2-ethyl-5-methyl-3,3-diphenylpyrroline by liquid chromatography tandem mass spectrometry.
RESULTS: There was large intersubject variability and no dose-concentration relationship for cumulative methadone dose and methadone, EDDP, 2-ethyl-5-methyl-3,3-diphenylpyrroline, or total concentrations in hair. For individual women, a positive trend was noted for cumulative methadone dose and methadone and EDDP concentrations in hair. There was a positive linear trend for cumulative methadone dose and EDDP/methadone ratio in maternal hair, perhaps reflecting methadone's induction of its own metabolism. Maternal methadone concentrations were higher than those in infant hair, and infant EDDP hair concentrations were higher than those in maternal hair. Maternal methadone dose, and methadone and EDDP hair concentrations were not correlated with peak infant neonatal abstinence syndrome (NAS) scores, days to peak NAS, duration of NAS, time to NAS onset, birth length, head circumference, or amount of neonatal morphine pharmacotherapy. Maternal cumulative third trimester methadone dose was positively correlated with infant birth weight.
CONCLUSIONS: Methadone and EDDP in pregnant women's hair are markers of methadone exposure and do not predict total methadone dose, nor neonatal outcomes from in utero methadone exposure.
Authors:
Sarah K Himes; Robert S Goodwin; Colleen M Rock; Hendrée E Jones; Rolley E Johnson; Diana G Wilkins; Marilyn A Huestis
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, N.I.H., Intramural    
Journal Detail:
Title:  Therapeutic drug monitoring     Volume:  34     ISSN:  1536-3694     ISO Abbreviation:  Ther Drug Monit     Publication Date:  2012 Jun 
Date Detail:
Created Date:  2012-05-16     Completed Date:  2013-03-11     Revised Date:  2014-09-13    
Medline Journal Info:
Nlm Unique ID:  7909660     Medline TA:  Ther Drug Monit     Country:  United States    
Other Details:
Languages:  eng     Pagination:  337-44     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Female
Hair / chemistry,  metabolism*
Humans
Infant, Newborn
Methadone / metabolism*,  therapeutic use
Neonatal Abstinence Syndrome / diagnosis,  metabolism
Opiate Substitution Treatment / adverse effects,  methods
Opioid-Related Disorders / drug therapy,  metabolism*
Pregnancy
Prenatal Exposure Delayed Effects / diagnosis,  metabolism*
Young Adult
Grant Support
ID/Acronym/Agency:
DA 09096/DA/NIDA NIH HHS; DA 12220/DA/NIDA NIH HHS; DA 12403/DA/NIDA NIH HHS; M01RR-02719/RR/NCRR NIH HHS; R01 DA012220/DA/NIDA NIH HHS; R01 DA012220-04/DA/NIDA NIH HHS; Z01 DA000412-10/DA/NIDA NIH HHS; Z01 DA000412-11/DA/NIDA NIH HHS; ZIA DA000433-10/DA/NIDA NIH HHS; ZIA DA000433-11/DA/NIDA NIH HHS
Chemical
Reg. No./Substance:
UC6VBE7V1Z/Methadone
Comments/Corrections

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