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.

Comments:

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

Reference:

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.