Psychosocially-Assisted Pharmacological Treatment of Opioid Dependent Adults: A Systematic Review

Background: Opioid dependence is a conundrum that significantly contributes to global mortality, crimes, and transmission of diseases such as hepatitis (B and C), human immunodeficiency virus and perhaps, coronavirus disease 2019 (COVID-19). There are contradictory findings on the efficacy of psychosocially-assisted pharmacological treatment of opioid dependence in adults. Objective: The overall objective of this research is to investigate if psychosocially-assisted pharmacological therapy has significantly better effect than pharmacological therapy with regards treatment outcomes of opioid dependent adults. Methods: All methods employed in this study are in conformity with the preferred reporting items for systematic reviews and meta-analysis (PRISMA) framework for systematic review which involve identification, screening, eligibility and inclusion. This systematic review involved PubMed literature search on randomized controlled trials published between 1st January 2015 to 1st October 2021. Results: PubMed search yielded 5,216 articles which were screened using inclusion and exclusion criteria resulting in 19 articled being retained for data extraction. Of the 19 articles used in this study, 13 (68.4%) articles having a combined sample size of 1,928 (60.6%) showed that addition of psychosocial intervention to pharmacotherapy significantly improved abstinence from opioid abuse. Conclusion: The outcome of evaluation of the overall evidences presented in the 19 articles used in this study is that psychosocially-assisted pharmacological therapy is significantly better than pharmacological treatment with respect to enhancement of abstinence from opioid abuse among opioid-dependent adults. Additionally, this study has provided specific combinations of psychosocial and pharmacological treatment that can produce significant beneficial effect on opioid abstinence. The huge downturn in randomized controlled trials on treatment of opioid dependence among adults has been highlighted in this study.

Psychopharmacological Properties of the Saponin Fraction of Ficus Platyphylla Stem Bark

The psychopharmacological effects of a saponin-rich fraction (SFG) obtained from crude methanolic extract of Ficus platyphylla stem bark were studied on spontaneous motor activity (SMA); pentobarbitalinduced sleep; motor coordination; amphetamine-induced hyperactivity and stereotyped behaviour; catalepsy; forced swim and tail suspension tests in rodents. SFG reduced SMA dose dependently; suggesting that it may contain psychoactive principles with sedative effects. The fraction shortened the onset and prolonged the duration of pentobarbital-induced sleep; which confirmed its sedative properties. The fraction diminished immobility time in forced swim and tail suspension tests; which is indicative of antidepressant properties. It attenuated amphetamine-induced hyperactivity and stereotyped behaviour; induced catalepsy and exacerbated haloperidol-induced catalepsy in rodents; but had no effect on motor coordination in the treadmill experiment at the doses tested. These effects were similar to those of classical neuroleptics and antidepressants. Our study provides scientific evidence of psychopharmacological effects of the saponin fraction of Ficus platyphylla stem bark and therefore supports further development of its psychoactive components as antipsychotics and antidepressants