Cited by 56Substance Abuse Treatment and OutcomesOpioid Use Disorder TreatmentNeurotransmitter Receptor Influence on Behavior

Efficacy and safety of psychostimulants for amphetamine and methamphetamine use disorders: a systematic review and meta-analysis

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Bhatt, Meha, Zielinski, Laura, Baker-Beal, Lola, Bhatnagar, Neera, Mouravska, Natalia, Laplante, Phillip, Worster, Andrew, Thabane, Lehana +1 more·2016·Systematic Reviews

Abstract

BACKGROUND: Amphetamine and methamphetamine use disorders are associated with severe health and social consequences. No pharmacological therapy has been approved for the treatment of these disorders. Psychostimulants can act as maintenance-like therapies for managing substance use among these patients. The aim of this study is to evaluate the literature examining the efficacy and safety of psychostimulant agents for increasing abstinence and treatment retention among patients with amphetamine and methamphetamine use disorders. METHODS: We searched MEDLINE, EMBASE, PsycInfo, Cochrane Central, and CINAHL from inception to August 2016. Selection of studies, data extraction, and risk of bias assessment were conducted independently by two reviewers. We conducted meta-analyses to provide a pooled summary estimate for included trials and report the review according to PRISMA guidelines. RESULTS: We identified and selected 17 studies with 1387 participants. Outcome reporting across trials was inconsistent, and the overall quality of evidence was very low due to high risk of bias and indirectness. A meta-analysis of five trials (642 participants) found no effect of psychostimulants for end-of-study abstinence (odds ratio = 0.97, 95% confidence interval 0.65 to 1.45). Additionally, the pooled estimate from 14 studies (1184 participants) showed no effect of psychostimulants for treatment retention (odds ratio = 1.20, 95% confidence interval = 0.91 to 1.58). The incidence of serious adverse events did not differ between intervention and placebo groups based on qualitative reports from trials. CONCLUSIONS: Quantitative analyses showed no effect of psychostimulants for sustained abstinence or treatment retention. We also identified the need for more rigorous studies in this research area with clinician and patient important outcomes.

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  • The included systematic review [108] concluded there was no evidence of an effect of psychostimulants on terminal abstinence and treatment retention in the context of amphetamine and methamphetamine use disorder.

    “Review authors from both SRs concluded that there was no evidence of an effect of psychostimulants on terminal abstinence (i.e., maintaining abstinence from methamphetamine at the end of the trial) and treatment retention in the context of amphetamine and methamphetamine use disorder [108]”
  • Using AMSTAR-2, the systematic review [108] was rated low quality due to one critical flaw and two non-critical weaknesses.

    “Using the AMSTAR-2 instrument (assessments provided in S6 Text), one review was rated to be of low quality [108] due to the presence of one critical flaw (i.e., did not provide a list of studies evaluated at full-text that were excluded) and two non-critical weaknesses (i.e., did not describe for inclusion of study designs, did not perform data extraction in duplicate);”

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Authors
Bhatt, M., Zielinski, L., Baker-Beal, L., Bhatnagar, N., Mouravska, N., Laplante, P., Worster, A., Thabane, L., & Samaan, Z.
Affiliations
  • McMaster University (CA)
  • St George's, University of London (GB)
  • Juravinski Hospital (CA)
  • St. Joseph’s Healthcare Hamilton (CA)
  • Peter Boris Centre for Addictions Research (CA)
Corresponding author
Samaan, Zainab
Venue
Systematic Reviews
Published
2016-11-14
Volume
5
Issue
1
Pages
189-189
ISSN
2046-4053 (ISSN-L)
OpenAlex
W2555084569
Cited by
56
References
42
Citations by year
2026: 1 · 2025: 5 · 2024: 9 · 2023: 7 · 2022: 7 · 2021: 4 · 2020: 11 · 2019: 8 · 2018: 3
FWCI
0.50
Type
journal article
Language
en
Open access
Locations
  • Systematic Reviews (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Funders
Hamilton Academic Health Sciences Organization (HAH-16-04)
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
psychostimulants, amphetamine use disorder, methamphetamine dependence, addiction treatment, abstinence, treatment retention, adverse events, maintenance therapy
MeSH terms
Central Nervous System Stimulants, Humans, Methamphetamine, Amphetamine-Related Disorders

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