4.2 Review

Pharmacotherapeutic strategies for methamphetamine use disorder: mind the subgroups

期刊

EXPERT OPINION ON PHARMACOTHERAPY
卷 20, 期 18, 页码 2273-2293

出版社

TAYLOR & FRANCIS LTD
DOI: 10.1080/14656566.2019.1681970

关键词

Drug use disorder; clinical trials; methamphetamine; pharmacotherapy; subgroups

资金

  1. Fundacao para a Ciencia e Tecnologia (FCT, Portugal)
  2. Speed, crash and run: exersomes boost neuroenergetics and mood in mice on speed project (MOOD EXERsomes) [POCI-01-0145-FEDER-030786]
  3. COMPETE-FEDER [POCI-01-0145-FEDER-007440]
  4. Centro 2020 Regional Operational Programmes [CENTRO-01-0145-FEDER -000012: HealthyAging2020, CENTRO-01-0145-FEDER- 000008: BrainHealth 2020]
  5. [UID/NEU/04539/2013]
  6. [UID/NEU/04539/2019]
  7. Fundação para a Ciência e a Tecnologia [UID/NEU/04539/2019] Funding Source: FCT

向作者/读者索取更多资源

Introduction: 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. Areas covered: 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. Expert opinion: Overall, end-of-treatment abstinence, reduced METH use or lower relapse rates were seen on METH dependent subgroups or attained significance only following post hoc 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.

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