Early intervention in METH abuse by lowering METH intake is essential not only for preventing METH overdose, but also for subsequent interventions, as greater treatment participation is achieved when METH use is low 133. Consequently, behavioral therapies should remain the first line of treatment for MUD. In the future, a combination of cognitive therapy(ies) with medication(s), followed by an anti-METH vaccine to maintain low METH intake long-term, will likely work the best against MUD. The confidential and anonymous resource for persons seeking treatment for mental and substance use disorders in the United States and its territories. If you or a loved one is struggling with amphetamine addiction, American Addiction Centers (AAC) is here to help. We have trusted facilities across the country and are a leading provider of addiction treatment programs.
Amphetamines
Outcomes and measures to assess them varied widely, making it difficult to synthesise the data; pharmacotherapies were most often assessed in defined or biased populations, and study completion rates were low. Approved by the FDA in the early 2000s, Adderall is an amphetamine and dextroamphetamine combined. Abuse of methamphetamine can cause long-lasting brain damage along with other problems. The drug is typically made in clandestine laboratories with relatively inexpensive over-the-counter ingredients.
S3 Text. Full reference list of included trials.
- Consequently, behavioral therapies should remain the first line of treatment for MUD.
- In two studies, it was unclear if the outcome assessors were blinded in addition to the participants and personnel.
- The desired goal of pharmacotherapy will likely vary depending on the patient, and must be patient-focused and clinically relevant.
- ZFAND2A is a canonical heat shock gene in humans encoding a zinc-finger containing protein that is involved in the regulation of proteasomal protein degradation 58, 59.
- The medications that have shown the most promise as pharmacotherapies for MUD are bupropion and naltrexone administered together.
Dose titrations during this study were based on the subjects’ clinical response to the medication. In another study (Cruickshank 2008), participants were administered 15 mg of mirtazapine on the first two nights Amphetamine Addiction and 30 mg mirtazapine every night for the next 12 nights. In all four studies (Srisurapanont 1999b; Jittiwutikan 1997, Kongsakon 2005; Cruickshank 2008), the treatment duration was 14 days.
- The drug is typically made in clandestine laboratories with relatively inexpensive over-the-counter ingredients.
- Maintaining a review of outcomes from experiences using medications in clinical trials for amphetamine withdrawal is an important method for clinicians to stay current and to seek guidance regarding medication strategies when treating individuals in acute withdrawal from amphetamines.
- A single study has investigated ondansetron for the treatment of MA dependence 44.
Srisurapanont 1999b published and unpublished data
Amphetamine users may also use other drugs inappropriately to manage the side effects of amphetamines. Benzodiazepines, for example, are anti-anxiety agents that may be used to help an individual sleep, but that can also be addictive. D. Incomplete outcome data were considered for all outcomes except for discontinuation rates. Studies were considered at low risk of bias if they adequately addressed missing data.
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The efficacy of a purely behavioural intervention—such as CM alone—shows that financial rewards can compete with biological rewards mediated by cocaine and amphetamine cues and incentives 82. This seems to be true only if rewards are contingent upon the provision of drug-free urine samples, as non-contingent rewards were not shown to be effective (Fig 4). Indeed, CM strategies help individuals to overcome apathy or resistance to the recovery process.
Both types of medications, agonists and uptake blockers, increase monoaminergic neurotransmission. Some medications tested in clinical trials had dual actions, e.g., as monoamine stimulators and antidepressants. They included medications targeting opioid, γ-aminobutyric acid (GABA) or the cholinergic system. As aforementioned, the glutamatergic system plays a key role in MUD; consequently, several glutamatergic ligands have been evaluated for their efficacy to treat MUD as well.
- From the initially identified 7,261 citations, we retrieved 160 potentially eligible articles in full text (Fig 1).
- Contingency management interventions, which provide tangible incentives in exchange for engaging in treatment and maintaining abstinence, have also been shown to be effective.
- In 2006, 24.7 million individuals aged 15‐64 consumed amphetamine type stimulants (UNODC 2008).
- In addition to not being widely available 117, a limitation of behavioral therapies is the finding that they have moderate and variable efficacy in terms of abstinence and retention and still result in limited long-term recovery and subsequently relapse.
- A summary of the reviewed studies is presented in Table 4, and an extended version is available in Supplementary Table 1 (see ESM).
Results of Individual Studies
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3 Treatment of Withdrawal Symptoms
At present, there is no evidence to guide selection of medications that might relieve symptoms of amphetamine withdrawal for patients in initial abstinence from chronic amphetamine use. In summary, the results showed some benefits of amineptine in the treatment of amphetamine withdrawal, as seen in the discontinuation rate and improvements in the global state as measured by CGI. Mirtazapine was no more effective than placebo in terms of discontinuation rate, improvements on global state, and reduction in withdrawal symptoms based on the results of one study (Cruickshank 2008). Research on the science of addiction and the treatment of substance use disorders has led to the development of research-based methods that help people to stop using drugs and resume productive lives, also known as being in recovery. Cocaine and amphetamine addiction is highly prevalent in the world and is incredibly costly economically.
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