Bupropion for the treatment of methamphetamine dependence
Abstract
Bupropion was tested for efficacy in increasing weeks of abstinence in methamphetamine-dependent patients, compared to placebo. This was a double-blind placebo-controlled study, with 12 weeks of treatment and a 30-day follow-up. Five outpatient substance abuse treatment clinics located west of the Mississippi participated in the study. One hundred and fifty-one treatment-seekers with DSM-IV diagnosis of methamphetamine dependence were consented and enrolled. Seventy-two participants were randomized to placebo and 79 to sustained-release bupropion 150 mg twice daily. Patients were asked to come to the clinic three times per week for assessments, urine drug screens, and 90-min group psychotherapy. The primary outcome was the change in proportion of participants having a methamphetamine-free week. Secondary outcomes included: urine for quantitative methamphetamine, self-report of methamphetamine use, subgroup analyses of balancing factors and comorbid conditions, addiction severity, craving, risk behaviors for HIV, and use of other substances. The generalized estimating equation regression analysis showed that, overall, the difference between bupropion and placebo groups in the probability of a non-use week over the 12-week treatment period was not statistically significant (p=0.09). Mixed model regression was used to allow adjustment for baseline factors in addition to those measured (site, gender, level of baseline use, and level of symptoms of depression). This subgroup analysis showed that bupropion had a significant effect compared to placebo, among male patients who had a lower level of methamphetamine use at baseline (p<0.0001). Comorbid depression and attention-deficit/hyperactivity disorder did not change the outcome. These data suggest that bupropion, in combination with behavioral group therapy, was effective for increasing the number of weeks of abstinence in participants with low-to-moderate methamphetamine dependence, mainly male patients, regardless of their comorbid condition.
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Various pharmacologic and psychosocial therapies for MUD/PMU have been explored in the literature.
“Although various pharmacologic (e.g., bupropion [22, 23], mirtazapine [24, 25], varenicline [26]) and psychosocial (e.g., cognitive behavioural therapy [27], contingency management [28, 29], Matrix model [30]) therapies for MUD/PMU have been explored in the literature, the best approach to treatment remains unclear.”
From Psychosocial and pharmacologic interventions for problematic methamphetamine use: Findings from a scoping review of the literature (2023) · cites this paper as [22]
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 [25]
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- Authors
- Elkashef, A. M., Rawson, R. A., Anderson, A. L., Li, S.-H., Holmes, T., Smith, E. V., Chiang, N., Kahn, R., Vocci, F., Ling, W., Pearce, V. J., McCann, M., Campbell, J., Gorodetzky, C., Haning, W., Carlton, B., Mawhinney, J., & Weis, D.
- Affiliations
- National Institutes of Health (US)
- University of California, Los Angeles (US)
- Stanford Medicine (US)
- Matrix Institute on Addictions (US)
- University of Missouri–Kansas City (US)
- IQVIA (United Kingdom) (GB)
- University of Hawaiʻi at Mānoa (US)
- Corresponding author
- Elkashef, Ahmed M
- ORCID
- Venue
- Neuropsychopharmacology
- Published
- 2007-06-20
- Volume
- 33
- Issue
- 5
- Pages
- 1162-1170
- ISSN
- 0893-133X (ISSN-L)
- 1740-634X
- OpenAlex
- W2003590685
- Cited by
- 234
- References
- 42
- Citations by year
- 2026: 12 · 2025: 7 · 2024: 8 · 2023: 13 · 2022: 9 · 2021: 9 · 2020: 6 · 2019: 5 · 2018: 10 · 2017: 8 · 2016: 15 · 2015: 16 · 2014: 22 · 2013: 19 · 2012: 14
- FWCI
- 10.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Neuropsychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Drug Abuse (N01DA-3-8824, N01-DA-0-8804)
- 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, cocaine dependence, abstinence, bupropion sustained release, group therapy, comorbid depression, attention deficit hyperactivity disorder, craving, HIV risk behavior, substance use disorders
- MeSH terms
- Adult, Double-Blind Method, Female, Follow-Up Studies, Humans, Male, Methamphetamine, Middle Aged, Mississippi, Psychotherapy, Severity of Illness Index, Bupropion, Treatment Outcome, Dopamine Uptake Inhibitors, Amphetamine-Related Disorders
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