Pregnancy methadone

Jaffe JH Drug dependence opioids, nonnarcotics, nicotine (tobacco), and caffeine, in Comprehensive Textbook of Psychiatry, 5th Edition, Vol 1. Edited by Kaplan HI, Sadock BJ. Baltimore, Williams c Wilkins, 1989, pp 642-686 Jaffe J, Knapp CM, Ciraulo DA Opiates clinical aspects, in Substance Abuse A Comprehensive Textbook. Edited by Lowinson JH, Ruiz P, Millman RB, et al. New York, Lippincott Williams and Wilkins, 2004, pp 158—165 Jarvis MA, Schnoll SH Methadone use dming pregnancy. NIDA Res Monogr 149 58— 77, 1995... 

Maany I, Dhopesh V, Arndt lO, et al Increase in desipramine serum levels associated with methadone treatment. Am J Psychiatry 146 1611—1613, 1989 Maas U, Kattner E, Weingart-Jesse B, et al Infrequent neonatal opiate withdrawal following maternal methadone detoxification during pregnancy. J Perinat Med 18 111-118, 1990... 

Senay EC Methadone maintenance treatment. Int J Addict 20 803—821, 1985 Senay EC, Dorus W, Goldberg F, et al Withdrawal from methadone maintenance rate of withdrawal and expectation. Arch Gen Psychiatry 34 361—367, 1977 Sharpe C, Kuschel C Outcomes of infants born to mothers receiving methadone for pain management in pregnancy. Arch Dis Child Fetal Neonatal Ed 89 F33—F36, 2004... 

Chasnoff et al. (1984) have reported on the developmental outcome of three groups of children, from birth until 2 years of age. The methadone, polydrug, and control groups demonstrated a downward trend in scores in the Bayley Scales of Infant Development. Their interpretation is that the infants environment and subsequent lack of stimulation has a more direct influence on long-term development than does maternal use of drugs during pregnancy. 

The effects of PCP, heroin, and methadone upon the developing fetus may indeed be different. We have found that the PCP infants are more deviant in their development than the reported development of the heroin and methadone infants. Our concerns about stating that drug use by the mothers during pregnancy does not affect developmental outcome are great. 

Burns L, Mattick RP, Lim K Wallace C (2006). Methadone in pregnancy treatment retention and neonatal outcomes. Addiction, 102,264-70... 

Contraindications to interferon alfa therapy include hepatic decompensation, autoimmune disease, and history of cardiac arrhythmia. Caution is advised in the setting of psychiatric disease, epilepsy, thyroid disease, ischemic cardiac disease, severe renal insufficiency, and cytopenia. Alfa interferons are abortifacient in primates and should not be administered in pregnancy. Potential drug-drug interactions include increased theophylline levels and increased methadone levels. Co-administration with didanosine is not recommended because of a risk of hepatic failure, and co-administration with zidovudine may exacerbate cytopenias. 

D.E. Hutchings, Methadone and heroin during pregnancy A review of behavioral effects in human and animal offspring, Neurobehav. Toxicol. Teratol., 4(4) (1982) 429-434. 

The neonatal abstinence syndrome occurs in 30-80% of infants whose mothers have taken opiates during pregnancy. The incidence is higher in those whose mothers have a history of opioid dependence and are taking methadone maintenance than in those who are taking methadone for chronic pain (39). The methadone blood concentration may be a useful predictor of the likelihood of severe withdrawal requiring treatment, but clinical assessment by a standardized scoring system is still required to determine the need to treat the neonatal abstinence syndrome (40). 

Methadone is extensively used in opioid withdrawal and maintenance programs (see Drug tolerance in this monograph), and has been safely used for this purpose in pregnancy, with only mild effects on the offspring (41). However, fetal exposure to methadone in utero can cause a neonatal abstinence syndrome after delivery. 

A newborn girl born of an HIV-positive mother who took antiretroviral drugs and methadone during pregnancy developed a methadone abstinence syndrome at day 7 (43). She was HIV-negative and was treated symptomatically for 15 days with chlorpromazine. The platelet count was 1049 x 109/1 on day 17 and fell progressively to 290 x 109/1 at 8 weeks. The authors suggested that the thrombocytosis had been secondary to intrauterine methadone exposure. 

Sharpe C, Kuschel C. Outcomes of infants bom to mothers receiving methadone for pain management in pregnancy. Arch Dis Child Fetal Neonatal Ed 2004 89 F33-F36. 

Pond SM, Kreek MJ, Tong TG, Raghunath J, Benowitz NL. Altered methadone pharmacokinetics in methadone-maintained pregnancy women. J Pharmacol Exp Ther 1985 233 1-6. 

In patients with reduced respiratory reserve, such as those with emphysema, severe obesity, cor pulmonale, and kyphoscoliosis, opioids must be used with caution. The relative benefits and harms of using opioids in patients taking monoamine oxidase inhibitors, those with a history of drug abuse, asthma, hepatic impairment, hypotension, raised intracranial pressure, or head injury, and during pregnancy or breast feeding, should be carefully considered. Dextropropoxyphene, pethidine, and methadone should be used with caution (SEDA-21, 85). 

Alcohol, barbiturates, and narcotics—such as diphenhydramine (Benadryl), amobarbital (Amytal), diazepam (Valium), codeine, heroin, methadone, morphine, propoxyphene (Darvon)—that are used during pregnancy can lead to harmful effects on the newborn. Use of these dmgs during pregnancy can create an addiction in the newborn. The baby will go into withdrawal from the drug when they are born. This can result in hyperactivity, crying, irritability, seizures and even sudden death. 

Wolff K, Boys A, Rostami-Hodjegan A, Hay A, Ra-istrick D (2005) Changes to methadone clearance during pregnancy. Eur J Clin Pharmacol 61 763-768... 

Pregnancy In a retrospective cohort study of 258 opiate-addicted gravid women taking methadone there was an increased rate of preterm birth of 29%, almost three times the national average (11%). [118. ... 

Wouldes TA, Woodward U. Maternal methadone dose during pregnancy and infant clinical outcome. Neurotoxicol Ter-... 

In a similar study, involving 450 singleton pregnancies in drug misusing women taking methadone, 46% of the neonates developed the neonatal abstinence syndrome [27 1. Breastfeeding was associated with amelioration of symptoms. Admissions to... 

Pregnancy Preterm births were reported as being more prevalent in 258 opiate-addicted pregnant women who were taking methadone in a retrospective cohort study [93 ]. The preterm rate was 29% (almost 3 times the national average of 11%). The higher rate was not affected by medical or infectious co-morbidity, but there was a correlation between preterm birth and the use of more than one substance. 

Pregnancy The roles of buprenorphine and methadone in the clinical management of opioid dependence during pregnancy and breast feeding have been reviewed [190 ]. The dosages must be tailored to the needs of each opioid-dependent pregnant woman. 

Dryden C, Young D, Hepburn M, MacTier H. Maternal methadone use in pregnancy factors associated with the development of neonatal abstinence syndrome and imphcations for healthcare resources. BJOG 2009 116(5) 665-71. 

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