Original ContributionsActigraphic Measurements in Opioid Detoxification With Methadone or BuprenorphinePjrek, Edda MD*; Frey, Richard MD*; Naderi-Heiden, Angela MD*; Strnad, Alexandra MD*; Kowarik, Alexander MSc†; Kasper, Siegfried MD*; Winkler, Dietmar MD*Author Information From the *Department of Psychiatry and Psychotherapy, Medical University of Vienna; and †Data-analysis OG, Vienna, Austria. Received February 3, 2011; accepted after revision July 21, 2011. Reprints: Dietmar Winkler, MD, Department of Psychiatry and Psychotherapy, Medical University of Vienna, Währinger Gürtel 18-20, A-1090 Vienna, Austria (e-mail: [email protected]). Journal of Clinical Psychopharmacology: February 2012 - Volume 32 - Issue 1 - p 75-82 doi: 10.1097/JCP.0b013e31823f91d1 Buy Metrics Abstract The objective of the present naturalistic study was to assess the differential effects of opioid detoxification with methadone or buprenorphine on activity, circadian rhythm, and sleep. Forty-two consecutive inpatients with opiate addiction were switched to either methadone or buprenorphine and gradually tapered down over the course of 2 to 3 weeks. There were no significant differences in comedication (lofexidine, quetiapine, and valproic acid) between the methadone and buprenorphine groups. Patients in the methadone group showed 11% lower activity and were 24 minutes phase delayed as compared with buprenorphine-treated patients, whereas the latter had 2.5% lower sleep efficiency and 9% shorter actual sleep time. These significant group differences were most pronounced for the lowest doses (≤20% of maximum individual daily dose, ie, at the end of withdrawal representing late withdrawal effects). Furthermore, for the total sample, we found a significant decrease in the relative amplitude of the sleep-wake cycle and worsening of all actigraphic sleep parameters from the higher (100% to 20%) to the lowest doses (20% to 0%). The acrophase of the circadian rhythm displayed a phase advance (−88 minutes) from the highest (100% to 80%) to the lower doses (80% to 0%) in methadone-treated patients. Opioid tapering with methadone or buprenorphine leads to characteristic changes of the rest-activity cycle, but further study is required to validate these results. © 2012 Lippincott Williams & Wilkins, Inc.