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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
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 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]
In the citing paper
“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]
In the citing paper
“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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Williams, D. M. (2019) · Cambridge University Press eBooks · doi:10.1017/9781316275047.022
Darwinian Hedonism and Political Will
Williams, D. M. (2019) · Cambridge University Press eBooks · doi:10.1017/9781316275047.029
Metadata
- 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
- 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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