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Cited by 70Substance Abuse Treatment and OutcomesOpioid Use Disorder TreatmentNeurotransmitter Receptor Influence on Behavior

Bupropion for the treatment of methamphetamine dependence in non-daily users: a randomized, double-blind, placebo-controlled trial

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Anderson, Ann L., Li, Shou-Hua, Markova, Denka, Holmes, Tyson H., Chiang, Nora, Kahn, Roberta, Campbell, Jan, Dickerson, Daniel L. +5 more·2015·Drug and Alcohol Dependence
DOI 10.1016/j.drugalcdep.2015.01.036PMC PMC4388163
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Abstract

Aim Bupropion was tested for efficacy to achieve methamphetamine (MA) abstinence in dependent, non-daily users.Methods A randomized, double-blind, placebo-controlled trial, with 12-week treatment and 4-week follow-up, was conducted with 204 treatment-seeking participants having MA dependence per DSM-IV, who used MA on a less-than-daily basis. 104 were randomized to matched placebo and 100 to bupropion, sustained-release 150mg, twice daily. Participants were seen three times weekly to obtain urine for MA and bupropion assays, study assessments, and thrice weekly, 90-min, group psychotherapy. There was no biomarker for placebo adherence. The primary outcome was achievement of abstinence throughout the last two weeks of treatment; 'success' requiring at least two urine samples during each of Weeks 11 and 12, and all samples MA-negative (<300ng/mL).Results Bupropion and placebo groups did not differ significantly in the percentage achieving abstinence for the last 2 weeks of treatment (chi-square, p=0.32). Subgroup analysis of participants with lower baseline MA use (≤18 of last 30 days before consent) also revealed no difference in success between groups (p=0.73). Medication adherence per protocol (detectable bupropion, >5ng/mL, in ≥50% of urine samples from Study Weeks 1-10 and ≥66% of urine samples from Weeks 11 to 12) was achieved by 47% of participants taking bupropion.Conclusions These data indicate that bupropion did not increase abstinence in dependent participants who were using MA less-than-daily. Medication non-adherence was a limitation in this trial. Psychosocial therapy remains the mainstay of treatment for MA dependence. Further research on subgroups who may respond to bupropion may be warranted.

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  • In a review by Elkashef et al, pharmacotherapies such as bupropion and sertraline did not increase abstinence from methamphetamine in groups who received this drug compared with controls.

    “In a review conducted by Elkashef et al,25 pharmacotherapies such as bupropion and sertraline did not increase abstinence from MA in groups who received this drug compared with controls.26”

    From Protocol for a systematic review of psychological treatment for methamphetamine use: An analysis of methamphetamine use and mental health symptom outcomes (2017) · cites this paper as [26]

    The Abstract Results and Discussion report that bupropion did not significantly increase methamphetamine abstinence compared with placebo in this trial of less-than-daily users. The paper is a bupropion trial, not a review by Elkashef et al., and the searched passages do not support the claim about sertraline. (LLM, conf=0.88)

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  • Limited information was identified on the appropriate medical workup for a patient who becomes intoxicated from a ruptured package of body-concealed stimulants.

    “limited information was identified on the appropriate medical workup for a patient who becomes intoxicated from a ruptured package of bodyconcealed stimulants.[251][252][253][254][255]”

    From The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder (2024) · cites this paper as [251]

    The Methods (§2.2–2.3; page unavailable) describe screening and urine testing for a methamphetamine-dependence treatment trial, not the medical workup of acute intoxication. The Safety section (§3.5; page unavailable) mentions an emergency-department visit but does not discuss a ruptured body-concealed package. Searches for package rupture, body packing, and emergency evaluation found no passage addressing the claim. (LLM, conf=0.78)

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Authors
Anderson, A. L., Li, S.-H., Markova, D., Holmes, T. H., Chiang, N., Kahn, R., Campbell, J., Dickerson, D. L., Galloway, G. P., Haning, W., Roache, J. D., Stock, C., & Elkashef, A. M.
Affiliations
  • National Institutes of Health (US)
  • Medivation, Inc. (United States) (US)
  • Stanford Medicine (US)
  • University of Kansas (US)
  • University of California, Los Angeles (US)
  • University of Hawaiʻi at Mānoa (US)
  • The University of Texas at San Antonio Health Science Center (US)
  • VA Salt Lake City Healthcare System (US)
Corresponding author
Anderson, Ann L.
ORCID
Venue
Drug and Alcohol Dependence
Publisher
Elsevier BV
Published
2015-05
Volume
150
Pages
170-174
ISSN
0376-8716 (ISSN-L)
DOI
10.1016/j.drugalcdep.2015.01.036
PMC
PMC4388163
OpenAlex
W1979313563
Cited by
70
References
21
Citations by year
2026: 5 · 2025: 2 · 2024: 8 · 2023: 12 · 2022: 6 · 2021: 7 · 2020: 2 · 2019: 7 · 2018: 5 · 2017: 6 · 2016: 7 · 2015: 3
FWCI
5.49
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Drug and Alcohol Dependence (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (n01da58857-13-0-1, Z99 DA999999)
  • National Institute on Drug Abuse (K25DA040032, N01 DA058857)
Topics
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
  • Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Neurotransmitter Receptor Influence on Behavior
Keywords
bupropion, methamphetamine dependence, abstinence, medication adherence, group therapy, pharmacotherapy, urine drug testing
MeSH terms
Adult, Double-Blind Method, Female, Humans, Male, Methamphetamine, Psychotherapy, Group, Bupropion, Treatment Outcome, Dopamine Uptake Inhibitors, Amphetamine-Related Disorders, Medication Adherence

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