Pharmacotherapeutic strategies for methamphetamine use disorder: mind the subgroups

: Drug use related deaths are increasing and the lack of effective treatment for psychostimulants can be largely held responsible. Particularly, no pharmacotherapy is approved for methamphetamine (METH) use disorder despite decades of research. Only psychosocial interventions are clinically used, wi...

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Published inExpert opinion on pharmacotherapy Vol. 20; no. 18; p. 2273
Main Authors Soares, Edna, Pereira, Frederico C
Format Journal Article
LanguageEnglish
Published England 12.12.2019
Subjects
Online AccessGet more information
ISSN1744-7666
DOI10.1080/14656566.2019.1681970

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Abstract : Drug use related deaths are increasing and the lack of effective treatment for psychostimulants can be largely held responsible. Particularly, no pharmacotherapy is approved for methamphetamine (METH) use disorder despite decades of research. Only psychosocial interventions are clinically used, with limited long-term recovery and relapse. : This review aims to select and describe the most relevant findings to date. Selected clinical trials were found in PubMed using the following keywords ('methamphetamine') and ('addiction' OR 'withdrawal' OR 'treatment' OR 'pharmacotherapy'). Randomized placebo-controlled trials enrolling treatment-seeking METH-dependent subjects and inherent secondary analysis were included. : Overall, end-of-treatment abstinence, reduced METH use or lower relapse rates were seen on METH dependent subgroups or attained significance only following analysis, irrespective of the medication tested. For example, light and heavy METH users seem to respond differently to pharmacotherapy. This together with the heterogeneous nature of the METH dependent population strongly suggests that some drugs herein described (e.g. mirtazapine, methylphenidate) should be further tested in clinical trials focused on subgroups. Lastly, objective measures, such as urinalysis, are mandatory to include in clinical trials and early treatment response and/or medication compliance should be carefully monitored and considered as predictors of success/failure.
AbstractList : Drug use related deaths are increasing and the lack of effective treatment for psychostimulants can be largely held responsible. Particularly, no pharmacotherapy is approved for methamphetamine (METH) use disorder despite decades of research. Only psychosocial interventions are clinically used, with limited long-term recovery and relapse. : This review aims to select and describe the most relevant findings to date. Selected clinical trials were found in PubMed using the following keywords ('methamphetamine') and ('addiction' OR 'withdrawal' OR 'treatment' OR 'pharmacotherapy'). Randomized placebo-controlled trials enrolling treatment-seeking METH-dependent subjects and inherent secondary analysis were included. : Overall, end-of-treatment abstinence, reduced METH use or lower relapse rates were seen on METH dependent subgroups or attained significance only following analysis, irrespective of the medication tested. For example, light and heavy METH users seem to respond differently to pharmacotherapy. This together with the heterogeneous nature of the METH dependent population strongly suggests that some drugs herein described (e.g. mirtazapine, methylphenidate) should be further tested in clinical trials focused on subgroups. Lastly, objective measures, such as urinalysis, are mandatory to include in clinical trials and early treatment response and/or medication compliance should be carefully monitored and considered as predictors of success/failure.
Author Pereira, Frederico C
Soares, Edna
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  givenname: Frederico C
  surname: Pereira
  fullname: Pereira, Frederico C
  organization: Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal
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Keywords clinical trials
subgroups
methamphetamine
Drug use disorder
pharmacotherapy
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Snippet : Drug use related deaths are increasing and the lack of effective treatment for psychostimulants can be largely held responsible. Particularly, no...
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StartPage 2273
SubjectTerms Amphetamine-Related Disorders - drug therapy
Central Nervous System Stimulants - administration & dosage
Central Nervous System Stimulants - adverse effects
Humans
Male
Methamphetamine - adverse effects
Methylphenidate - therapeutic use
Randomized Controlled Trials as Topic
Title Pharmacotherapeutic strategies for methamphetamine use disorder: mind the subgroups
URI https://www.ncbi.nlm.nih.gov/pubmed/31671001
Volume 20
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