Randomized controlled trial of dexamphetamine maintenance for the treatment of methamphetamine dependence.

Pharmacotherapies Research Unit, Drug and Alcohol Services South Australia, South Australia, Australia.
Addiction (Impact Factor: 4.6). 10/2009; 105(1):146-54. DOI: 10.1111/j.1360-0443.2009.02717.x
Source: PubMed

ABSTRACT To investigate the safety and efficacy of once-daily supervised oral administration of sustained-release dexamphetamine in people dependent on methamphetamine.
Randomized, double-blind, placebo-controlled trial.
Forty-nine methamphetamine-dependent drug users from Drug and Alcohol Services South Australia (DASSA) clinics.
Participants were assigned randomly to receive up to 110 mg/day sustained-release dexamphetamine (n = 23) or placebo (n = 26) for a maximum of 12 weeks, with gradual reduction of the study medication over an additional 4 weeks. Medication was taken daily under pharmacist supervision.
Primary outcome measures included treatment retention, measures of methamphetamine consumption (self-report and hair analysis), degree of methamphetamine dependence and severity of methamphetamine withdrawal. Hair samples were analysed for methamphetamine using liquid chromatography-mass spectrometry.
Treatment retention was significantly different between groups, with those who received dexamphetamine remaining in treatment for an average of 86.3 days compared with 48.6 days for those receiving placebo (P = 0.014). There were significant reductions in self-reported methamphetamine use between baseline and follow-up within each group (P < 0.0001), with a trend to a greater reduction among the dexamphetamine group (P = 0.086). Based on hair analysis, there was a significant decrease in methamphetamine concentration for both groups (P < 0.0001). At follow-up, degree of methamphetamine dependence was significantly lower in the dexamphetamine group (P = 0.042). Dexamphetamine maintenance was not associated with serious adverse events.
The results of this preliminary study have demonstrated that a maintenance pharmacotherapy programme of daily sustained-release amphetamine dispensing under pharmacist supervision is both feasible and safe. The increased retention in the dexamphetamine group, together with the general decreases in methamphetamine use, degree of dependence and withdrawal symptom severity, provide preliminary evidence that this may be an efficacious treatment option for methamphetamine dependence.

  • Source
    Emerging Targets for Drug Addiction Treatment, 1 edited by Juan Canales, 10/2012: pages 17-62; Nova Science Publishers., ISBN: 978-1-62081-913-5
  • [Show abstract] [Hide abstract]
    ABSTRACT: Background: The objective of this randomized, double-blind, placebo-controlled study was to evaluate the efficacy of sustained-release methylphenidate (MPH-SR) in treatment of methamphetamine dependence. Methods: Fifty-six individuals who met DSM-IV-TR criteria for methamphetamine dependence participated in this 10-week trial. The participants were randomly allocated into two groups and received 18 to 54 mg/day sustained-released methylphenidate or placebo for 10 weeks. Craving was evaluated by a visual analogue craving scale every week. Urinary screening test for methamphetamine was carried out each week. The Beck Depression Inventory-II (BDI-II) was used to monitor participant depressive symptoms at baseline and bi-weekly during the treatment period. Results: At the end of the trial, the MPH-SR group was less methamphetamine positive compared to the placebo group and the difference was significant (p = 0.03). By the end of the study, MPH-SR group showed significantly less craving scores compared to the placebo group [MD (95% CI) = -10.28(0.88-19.18), t(54) = 2.19, p = 0.03]. There was greater improvement in the depressive symptoms scores in the intervention group compared to the placebo group [MD (95% CI) = 2.03(0.31-3.75), t (54) = 2.37, p = 0.02]. Conclusion: Sustained-released methylphenidate was safe and well tolerated among active methamphetamine users and significantly reduced methamphetamine use, craving and depressive symptoms.
    DARU Journal of Pharmaceutical Sciences 12/2015; 23(1). DOI:10.1186/s40199-015-0092-y · 1.11 Impact Factor
  • Source
    Neuropsychopharmacology: official publication of the American College of Neuropsychopharmacology 12/2014; DOI:10.1038/npp.2014.322 · 7.83 Impact Factor

Full-text (2 Sources)

Available from
Jul 4, 2014