Abstract
2019
Objectives To investigate the changes of brain dopamine transporters (DAT) in heroin users after short abstinence and maintenance treatment with Jitai tablets, a traditional Chinese medicine for the treatment of opiate addiction.
Methods SPECT with 99mTc-TRODAT-1 was performed in healthy subjects (n = 29) and detoxified heroin-dependent patients (n = 49). The patients were randomly assigned to maintenance with placebo (n = 27) or Jitai tablets (n = 22). Medications were administered on double-blind basis. The patients underwent second test after three-month treatment. Specific tracer uptake was assessed in the bilateral striatum (RS, right striatum; LS, left striatum).
Results The patients showed significant decreases in DAT density in the bilateral striatum (RS, 2.30 ± 0.22; LS, 2.29 ± 0.21) compared to the healthy subjects (RS, 2.94 ± 0.37; LS, 2.91 ± 0.39) (p < 0.001). Although brain DA transporters in the patients evaluated after detoxification (15 days after last use) and then retested after three-month maintenance showed increases in both placebo group (RS, from 2.34 ± 0.21 to 2.38 ± 0.24; LS, from 2.28 ± 0.19 to 2.39 ± 0.24) and Jitai tablets group (RS, from 2.26 ± 0.23 to 2.35 ± 0.40; LS, from 2.30 ± 0.24 to 2.35 ± 0.29), the increases were not significant (p > 0.05). The differences between placebo and Jitai tablets were not significant (p > 0.05).
Conclusions These findings support that chronic heroin use induces striatum dopamine terminals impairment, and suggest abstinence may reverse some of the alterations in brain DAT but the effect of short abstinence is not evident. Jitai tablets are not effective enough in enhancing the reversion during short maintenance treatment. The changes of brain DAT after protracted abstinence and Jitai tablets maintenance treatment are now being monitored.
Research Support 2008BA149B0