Sustained-Release Dexamphetamine Maintenance for Methamphetamine Dependence
Methamphetamine use disorders are common, but medication-assisted treatment options are lacking. This randomized double-blind placebo-controlled trial tested the efficacy of flexible daily dosing of sustained-release dexamphetamine versus placebo for 12 weeks among 49 methamphetamine-dependent subjects. No take-home doses were given. All subjects received 4 sessions of cognitive behavioral therapy.
- Subjects in the dexamphetamine group had significantly better treatment retention than those in the placebo group (86 versus 49 days) (p=0.014).
- Significant reductions in self-reported days of methamphetamine use were seen in both groups; however, the trend was greater in the dexamphetamine group (68 days down to 8 days) compared with the placebo group (71 days down to 13 days) (p=0.086).
- No serious side-effects were reported.
The most effective pharmacotherapies for addictive disorders currently available are for nicotine, opioid, and alcohol dependence. This study suggests that maintenance therapy with dexamphetamine might be a useful tool in the management of methamphetamine dependence as well. In light of the ravages of methamphetamine use disorders worldwide and the challenges of treating them, this modality would be a welcome addition to the clinical armamentarium.Peter D. Friedmann, MD, MPH
Longo M, Wickes W, Smout M, et al. Randomized controlled trial of dexamphetamine maintenance for the treatment of methamphetamine dependence. Addiction. 2010;105(1):146–154.