1. J Clin Endocrinol Metab. 2005 Jan;90(1):203-6. Epub 2004 Oct 13.
Plasma testosterone and sexual function in men receiving buprenorphine
maintenance for opioid dependence.
Bliesener N, Albrecht S, Schwager A, Weckbecker K, Lichtermann D, Klingmüller D.
Department of Clinical Biochemistry, Division of Endocrinology, University of
Bonn, Sigmund Freud Strasse 25, 53105 Bonn, Germany. email@example.com
High-dose methadone is well known to cause testosterone deficiency and sexual
dysfunction in opioid-dependent men. Buprenorphine is a new drug for the
pharmacotherapy of opioid dependence. Its influence on the gonadal axis has not
been investigated to date. We therefore assayed testosterone, free testosterone,
estradiol, SHBG, LH, FSH, and prolactin in 17 men treated with buprenorphine.
Thirty-seven men treated with high-dose methadone and 51 healthy blood donors
served as controls. Sexual function and depression were assessed using a
self-rating sexual function questionnaire and the Beck Depression Inventory.
Patients treated with buprenorphine had a significantly higher testosterone level
[5.1 +/- 1.2 ng/ml (17.7 +/- 4.2 nmol/liter) vs. 2.8 +/- 1.2 ng/ml (9.7 +/- 4.2
nmol/liter); P < 0.0001] and a significantly lower frequency of sexual
dysfunction (P < 0.0001) compared with patients treated with methadone. The
testosterone level of buprenorphine-treated patients did not differ from that of
healthy controls. In conclusion, we demonstrated for the first time that
buprenorphine, in contrast with high-dose methadone, seems not to suppress plasma
testosterone in heroin-addicted men. To this effect, buprenorphine was less
frequently related to sexual side effects. Buprenorphine might therefore be
favored in the treatment of opioid dependence to prevent patients from the
clinical consequences of methadone-induced hypogonadism.