Pharmacotherapy for Methamphetamine Dependence: A Review of the Pathophysiology of Methamphetamine Addiction and the Theoretical Basis and Efficacy of Pharmacotherapeutic Interventions

Rose, Mark E.; Grant, Jon E.

doi:10.1080/10401230802177656

Cited by 122Substance Abuse Treatment and OutcomesNeurotransmitter Receptor Influence on BehaviorOpioid Use Disorder Treatment

Pharmacotherapy for Methamphetamine Dependence: A Review of the Pathophysiology of Methamphetamine Addiction and the Theoretical Basis and Efficacy of Pharmacotherapeutic Interventions

Rose, Mark E., Grant, Jon E.·2008·Annals of Clinical Psychiatry

DOI 10.1080/10401230802177656

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Abstract

BACKGROUND: Methamphetamine (METH) dependence is a significant public health, criminal justice, and social service concern, and although abuse of this drug spans the past 40 years in the U.S., effective treatments have only recently been developed and evaluated. Psychosocial therapies comprise the mainstay of treatment, yet many patients experience ongoing impairments in mood, cognition, emotional control, and motivation, suggesting a role for pharmacotherapy. METHODS: A search of the literature was performed to identify drug therapies utilized with METH dependent patients and the outcome of these trials. RESULTS: With the exception of bupropion, most trials employing direct monoamine agonists yielded negative or inclusive results, a counterintuitive finding. Positive results were produced by a trial of the mixed monoamine agonist/antagonist mirtazapine and by several studies employing indirect dopamine- and glutamate-modulating GABA agonists. Most trials were hampered by high rates of subject attrition, mirroring the difficulty in treating these patients in the outpatient setting. CONCLUSIONS: Although considered preliminary, several therapeutic agents were identified that may prove beneficial in treating METH-dependent patients, including bupropion, mirtazapine, baclofen, and topiramate. Psychosocial therapy remains the cornerstone of treatment, and drug therapy should be regarded as an adjunct, rather than a replacement for psychosocial approaches.

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Pharmacotherapies have been used with the aim of improving treatment engagement and retention.
“Pharmacotherapies have been used in conjunction with the aim of improving treatment engagement and retention;21”
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 [21]
Treatment retention can be difficult for methamphetamine users in psychological treatment.
“Treatment retention can be difficult for MA users in psychological treatment.21”
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 [21]
Overall, psychological therapies remain the most effective treatment option for methamphetamine use, and pharmacotherapies may be used as an adjunct.
“Overall, it appears that psychological therapies remain the most effective treatment option for MA use, and that pharmacotherapies may be used as an adjunct.21”
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 [21]

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Authors: Rose, M. E., & Grant, J. E.
Affiliations: University of Minnesota (US)
ORCID: Grant, Jon E.
Venue: Annals of Clinical Psychiatry
Publisher: SAGE Publications
Published: 2008-08
Volume: 20
Issue: 3
Pages: 145-155
ISSN: 1040-1237 (ISSN-L)
1547-3325
DOI: 10.1080/10401230802177656
OpenAlex: W2123983203
Cited by: 121
References: 74
Citations by year: 2026: 1 · 2025: 3 · 2024: 4 · 2023: 2 · 2022: 3 · 2021: 4 · 2020: 3 · 2019: 42 · 2018: 2 · 2017: 3 · 2016: 8 · 2015: 5 · 2014: 4 · 2013: 5 · 2012: 4
FWCI: 7.14
Type: journal article
Language: en
Open access: closed
Locations: Annals of Clinical Psychiatry (publishedVersion)
PubMed (publishedVersion)
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: methamphetamine dependence, pharmacotherapy, bupropion, mirtazapine, baclofen, topiramate, GABA agonists, dopaminergic modulation, glutamate modulation, treatment discontinuation, psychosocial interventions, adjunctive therapy
MeSH terms: Amygdala, Central Nervous System Stimulants, Chronic Disease, Humans, Methamphetamine, Nucleus Accumbens, Recurrence, Neurotransmitter Agents, Amphetamine-Related Disorders

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Pharmacotherapy for Methamphetamine Dependence: A Review of the Pathophysiology of Methamphetamine Addiction and the Theoretical Basis and Efficacy of Pharmacotherapeutic Interventions

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