Methadone-related delirium prevalence, causes, and outcomes

Joseph Westermeyer, Paul Thuras, Gihyun Yoon, Bhanu Prakash Kolla, Tegan Batres-Y-Carr, Erica Dimitropoulos

Research output: Contribution to journalArticlepeer-review

Abstract

Goals consist of determining 5-year prevalence and recurrence of methadone-related delirium (MRD), along with causes, treatments, and outcomes. Sample comprised 81 patients in methadone maintenance treatment. Criteria for MRD encompassed delirium with high methadone serum levels plus alleviation of delirium upon lowering methadone serum levels. MRD occurred in 14 cases who had 25 episodes. MRD precipitants included physician prescribing (i.e., excessive methadone or medications slowing methadone metabolism), drug misuse, and renal-fluid alterations. Social affiliation (housing with family, intimate partner) reduced MRD; employment increased MRD. Recovery occurred in 23/25 episodes of MRD; two episodes progressed to dementia. Obtaining serum methadone levels fostered prompt recognition.

Original languageEnglish (US)
Pages (from-to)371-377
Number of pages7
JournalJournal of Nervous and Mental Disease
Volume207
Issue number5
DOIs
StatePublished - May 2019

Bibliographical note

Funding Information:
Jasbir Singh, PhD, and his associates measured methadone serum levels. Marion Warwick, MD, monitored methadone-dosing protocols. Gary Zielke, RPH, and colleagues guided the pharmaceutical services. Kathryn Lee, BSN, RN, collected and recorded clinical data reported in the manuscript. During an annual workshop at the American Academy of Addiction Psychiatry, Gregory Acampora, MD, and Carla Marienfeld, MD, provided valuable critique and comment to this project during its planning and implementation.

Publisher Copyright:
Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.

Keywords

  • Delirium
  • Maintenance
  • Methadone
  • Risk factors
  • Treatment methods
  • Treatment outcome

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