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This trial also evaluated whether improvements in depressive symptoms were mediated by opioid use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Analyzed data came from the OPTIMA study (clinicaltrials.gov identifier: NCT03033732), a pragmatic randomised controlled trial comparing flexible take-home dosing of BUP\/NX and methadone standard model of care for reducing opioid use in people with POUD. A total of 272 participants were recruited in four Canadian provinces. Participants were randomised 1:1 to BUP\/NX or methadone. After treatment induction, past two-week opioid use was measured using the Timeline Followback every two weeks for a total of 24 weeks. Depressive symptoms were measured with the Beck Depression Inventory at baseline, weeks 12 and 24.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Both BUP\/NX and methadone significantly reduced depressive symptoms at week 12 (a\u03b2\u2009\u00b1\u2009SE\u2009=\u2009\u22123.167\u2009\u00b1\u20091.233; P\u2009&lt;\u20090.001) and week 24 (a\u03b2\u2009\u00b1\u2009SE\u2009=\u2009\u22127.280\u2009\u00b1\u20091.285; P\u2009&lt;\u20090.001), with no interaction between type of treatment and time ( P\u2009=\u20090.284). Improvements in depressive symptoms were only partially mediated by a reduction in opioid use (proportion mediated\u2009=\u200936.8%; 95% confidence interval\u2009=\u2009\u22121.158 to \u22120.070; P\u2009=\u20090.015).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>BUP\/NX and methadone showed similar effectiveness in decreasing comorbid depressive symptoms in people with POUD. This effect was partially explained by a reduction in opioid use. As both treatments seem equally effective, clinicians are encouraged to tailor the selection of OAT to patients\u2019 needs and characteristics.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/07067437221145013","type":"journal-article","created":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T02:12:44Z","timestamp":1671070364000},"page":"572-585","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":12,"title":["Effects of Buprenorphine\/Naloxone and Methadone on Depressive Symptoms in People with Prescription Opioid Use Disorder: A Pragmatic Randomised Controlled Trial"],"prefix":"10.1177","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7969-9998","authenticated-orcid":false,"given":"Gabriel","family":"Bastien","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Addictology, Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada"},{"name":"Research Centre, Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al (CRCHUM), Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2787-2792","authenticated-orcid":false,"given":"Christina","family":"McAnulty","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Addictology, Faculty of Medicine, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada"},{"name":"Research Centre, Centre Hospitalier de l\u2019Universit\u00e9 de Montr\u00e9al (CRCHUM), Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Ledjiar","sequence":"additional","affiliation":[{"name":"Unit\u00e9 de recherche clinique appliqu\u00e9e, Centre hospitalier universitaire Ste-Justine, Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Eugenia","family":"Socias","sequence":"additional","affiliation":[{"name":"British Columbia Centre on Substance Use, Vancouver, British Columbia, Canada"},{"name":"Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bernard","family":"Le Foll","sequence":"additional","affiliation":[{"name":"Translational Addiction Research Laboratory, Campbell Family Mental Health Research Institute, Center for Addiction and Mental Health, Toronto, Ontario, Canada"},{"name":"Department of Pharmacology and Toxicology, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"},{"name":"Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada"},{"name":"Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, 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