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      Comparing Sexual Function between Opioid Dependents Consuming Methadone or Opium Tincture

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          Abstract

          Objective: Sexual dysfunction is a side effect of methadone maintenance therapy (MMT). Opium Tincture (OT) has been used as a maintenance treatment. This study aimed to determine and compare the trend of sexual function and its related factors during treatment with both drugs.

          Method : An observational study was designed to measure the blood tests including free and total testosterone, prolactin, and sex hormone-binding globulin and a battery of questionnaires, including demographics and drug use history, in 42 and 53 patients entering MMT and OT treatment before and 1 and 3 months after the treatment.

          Results: Significant changes in testosterone levels were observed in the MMT but not the OT group. The difference between the two groups was not significant. Neither between nor within changes in the sexual function and premature ejaculation scores were significant (P =0.370& 0.698). Anxiety levels were significantly different (P= 0.001) within and between groups. There was a considerable difference in the trend of depression changes in the OT group, but not different in MMT group and between the two groups.

          Conclusion: No difference was found between MMT and OT effects on sexual function variables. The decrease in Testosterone during the three months of MMT, was not associated with diminished sexual function. In the MMT group, anxiety levels diminished during treatment. It seems that decreased testosterone in the MMT group was compensated by improved anxiety. Gonadotropin levels may not be the sole determinant in sexual activity, and complex interaction of mood and anxiety, agonist levels, and gonadotropins are involved.

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          Most cited references41

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          An inventory for measuring depression.

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            The international index of erectile function (IIEF): a multidimensional scale for assessment of erectile dysfunction.

            To develop a brief, reliable, self-administered measure of erectile function that is cross-culturally valid and psychometrically sound, with the sensitivity and specificity for detecting treatment-related changes in patients with erectile dysfunction. Relevant domains of sexual function across various cultures were identified via a literature search of existing questionnaires and interviews of male patients with erectile dysfunction and of their partners. An initial questionnaire was administered to patients with erectile dysfunction, with results reviewed by an international panel of experts. Following linguistic validation in 10 languages, the final 15-item questionnaire, the international index of Erectile Function (IIEF), was examined for sensitivity, specificity, reliability (internal consistency and test-retest repeatability), and construct (concurrent, convergent, and discriminant) validity. A principal components analysis identified five factors (that is, erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction) with eigenvalues greater than 1.0. A high degree of internal consistency was observed for each of the five domains and for the total scale (Cronbach's alpha values of 0.73 and higher and 0.91 and higher, respectively) in the populations studied. Test-retest repeatability correlation coefficients for the five domain scores were highly significant. The IIEF demonstrated adequate construct validity, and all five domains showed a high degree of sensitivity and specificity to the effects of treatment. Significant (P values = 0.0001) changes between baseline and post-treatment scores were observed across all five domains in the treatment responder cohort, but not in the treatment nonresponder cohort. The IIEF addresses the relevant domains of male sexual function (that is, erectile function, orgasmic function, sexual desire, intercourse satisfaction, and overall satisfaction), is psychometrically sound, and has been linguistically validated in 10 languages. This questionnaire is readily self-administered in research or clinical settings. The IIEF demonstrates the sensitivity and specificity for detecting treatment-related changes in patients with erectile dysfunction.
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              Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence

              Cochrane Database of Systematic Reviews
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                Author and article information

                Journal
                Iran J Psychiatry
                Iran J Psychiatry
                IJPS
                Iranian Journal of Psychiatry
                Psychiatry & Psychology Research Center, Tehran University of Medical Sciences (Tehran, Iran )
                1735-4587
                2008-2215
                July 2021
                : 16
                : 3
                : 312-319
                Affiliations
                [1 ]Department of Neuroscience and Addiction Studies, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
                [2 ] Department of Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
                [3 ] Research Center for Cognitive and Behavioral Sciences, Tehran University of Medical Sciences, Tehran, Iran.
                [4 ] Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran.
                [5 ] Social Determinants of Health Research Center, Zanjan University of Medical Sciences, Zanjan, Iran.
                [6 ] Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran.
                Author notes
                [* ]Corresponding Author: Address: Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, South Kargar Avenue Tehran, Iran, Postal Code: 1333715914. Tel: 98-21 55412222, Fax: 98-21 55412232, Email: mokriazr@ 123456sina.tums.ac.ir
                Article
                IJPS-16-312
                10.18502/ijps.v16i3.6257
                8452837
                34616465
                80e1ab33-5c32-4642-9daf-5cc83d393b22
                Copyright © 2021 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.

                This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International license ( https://creativecommons.org/licenses/by-nc/4.0/). Non-commercial uses of the work are permitted, provided the original work is properly cited.

                History
                : 13 September 2020
                : 7 December 2020
                : 13 February 2021
                Categories
                Original Article

                Clinical Psychology & Psychiatry
                anxiety,opioid substitution therapy,opium,sexual dysfunction,testosterone

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