Journal
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
Volume 69, Issue 6, Pages 578-592Publisher
WILEY
DOI: 10.1111/j.1365-2125.2010.03639.x
Keywords
addiction; amphetamine; clinical trials; dependence; medication; methamphetamine; treatment
Categories
Funding
- MILDT (Mission Interministrielle de Lutte contre les Drogues et la Toxicomanie) INSERM
- Assistance Publique- H pitaux de Paris. Dr Weinstein (Israel)
- National Institute for Psychobiology (Israel)
- National Institute of Health, National Institute on Drug Abuse (NIDA) [5R01 DA016764- 05, U10 DA015815]
- National Institute on Alcohol Abuse and Alcoholism and a Department of Veterans Affairs
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Methamphetamine dependence is a serious worldwide public health problem with major medical, psychiatric, socioeconomic and legal consequences. Various neuronal mechanisms implicated in methamphetamine dependence have suggested several pharmacological approaches. A literature search from a range of electronic databases (PubMed, EMBASE, PsycInfo, the NIDA research monograph index and the reference list of clinicaltrials.gov) was conducted for the period from January 1985 to October 2009. There were no restrictions on the identification or inclusion of studies in terms of publication status, language and design type. A variety of medications have failed to show efficacy in clinical trials, including a dopamine partial agonist (aripiprazole), GABAergic agents (gabapentin) and serotonergic agents (SSRI, ondansetron, mirtazapine). Three double-blind placebo-controlled trials using modafinil, bupropion and naltrexone have shown positive results in reducing amphetamine or methamphetamine use. Two studies employing agonist replacement medications, one with d-amphetamine and the other with methylphenidate, have also shown promise. Despite the lack of success in most studies to date, increasing efforts are being made to develop medications for the treatment of methamphetamine dependence and several promising agents are targets of further research.
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