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Effects of oral methamphetamine on cocaine use: A randomized, double-blind, placebo-controlled trial

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Mooney, Marc E., Herin, David V., Schmitz, Joy M., Moukaddam, Nidal, Green, Charles E., Grabowski, John·2009·Drug and Alcohol Dependence

DOI 10.1016/j.drugalcdep.2008.10.016PMC PMC2742691

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Abstract

Background No medication is currently approved for the treatment of cocaine dependence, but several preclinical and clinical reports suggest agonist-like medications, e.g., amphetamine analogues, may be a productive strategy for medication development. Objective This current proof-of-concept study sought to evaluate the safety, tolerability, and effectiveness of methamphetamine as a candidate treatment for cocaine dependence. Methods A randomized, double-blind, placebo-controlled study served to evaluate three treatment conditions in 82 cocaine-dependent individuals: (1) placebo (0mg, 6x/day; n=27), (2) immediate release (IR) methamphetamine (5mg, 6x/day; n=30), (3) sustained release (SR) methamphetamine (30 mg first pill, 1x/day; 0mg 5x/day; n=25). The study employed a sequential, two-phase design (i.e., 4 weeks of medication and counseling followed by 4 weeks of medication/counseling plus a contingency management procedure). Results Both preparation forms of methamphetamine were well-tolerated, with similar retention to placebo (0mg, 33%; 30 mg IR, 30%, 30 mg SR, 32%). Methamphetamine SR was associated with decreased sleep and increased weight loss. Medication adherence rates were high for the first dose of the day (95%), while adherence for subsequent capsules was lower. Those in the SR condition exhibited consistently lower rates of cocaine-positive urine samples (0mg, 60%; 30 mg IR, 66%; 30 mg SR, 29%), p<0.0001, and reported the greatest reduction in craving for cocaine, p<0.05. Conclusions SR methamphetamine significantly reduced cocaine use and craving. Additional research is warranted to develop and evaluate agonist-like medications that may effectively treat cocaine dependence.

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Authors: Mooney, M. E., Herin, D. V., Schmitz, J. M., Moukaddam, N., Green, C. E., & Grabowski, J.
Affiliations: University of Minnesota (US)
Corresponding author: Mooney, Marc E.
ORCID: Schmitz, Joy M.
Moukaddam, Nidal
Green, Charles E.
Venue: Drug and Alcohol Dependence
Publisher: Elsevier BV
Published: 2009-04
Volume: 101
Issue: 1-2
Pages: 34-41
ISSN: 0376-8716 (ISSN-L)
DOI: 10.1016/j.drugalcdep.2008.10.016
PMC: PMC2742691
OpenAlex: W2008441751
Cited by: 124
References: 54
Citations by year: 2026: 2 · 2025: 3 · 2024: 5 · 2023: 3 · 2022: 4 · 2021: 6 · 2020: 4 · 2019: 7 · 2018: 4 · 2017: 3 · 2016: 13 · 2015: 13 · 2014: 14 · 2013: 9 · 2012: 14
FWCI: 4.96
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Drug and Alcohol Dependence (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (5p50da009262-20)
National Institute on Drug Abuse (#P50 DA009262, R01DA016305, R00DA023548, K99DA023548, P50DA09262, L30 DA023817, R01-DA16305, K01DA019446, K01-DA-023548)
Topics: Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
Keywords: cocaine dependence, methamphetamine, cocaine craving, sustained-release formulation, medication adherence, contingency management, treatment retention, drug use reduction, sleep reduction, weight loss
MeSH terms: Adolescent, Adult, Affect, Central Nervous System Stimulants, Blood Pressure, Body Weight, Delayed-Action Preparations, Double-Blind Method, Female, Heart Rate, Humans, Male, Methamphetamine, Middle Aged, Riboflavin, Substance Abuse Detection, Treatment Outcome, Cocaine-Related Disorders, Young Adult

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Effects of oral methamphetamine on cocaine use: A randomized, double-blind, placebo-controlled trial

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