TY - JOUR
KW - Amphetamine-Related Disorders/drug therapy
KW - Central Nervous System Stimulants/administration & dosage/adverse effects
KW - Humans
KW - Male
KW - Methamphetamine/adverse effects
KW - Methylphenidate/therapeutic use
KW - Randomized Controlled Trials as Topic
KW - Drug use disorder
KW - Clinical Trials
KW - Methamphetamine
KW - pharmacotherapy
KW - subgroups
AU - E. Soares
AU - F. C. Pereira
A1 - 
AB - Introduction: Drug use related deaths are increasing and the lack of effective treatment for psychostimulants can be largely held responsible. Particularly, no pharmacotherapy is approved for methamphetamine (METH) use disorder despite decades of research. Only psychosocial interventions are clinically used, with limited long-term recovery and relapse.Areas covered: This review aims to select and describe the most relevant findings to date. Selected clinical trials were found in PubMed using the following keywords ('methamphetamine') and ('addiction' OR 'withdrawal' OR 'treatment' OR 'pharmacotherapy'). Randomized placebo-controlled trials enrolling treatment-seeking METH-dependent subjects and inherent secondary analysis were included.Expert opinion: Overall, end-of-treatment abstinence, reduced METH use or lower relapse rates were seen on METH dependent subgroups or attained significance only following post hoc analysis, irrespective of the medication tested. For example, light and heavy METH users seem to respond differently to pharmacotherapy. This together with the heterogeneous nature of the METH dependent population strongly suggests that some drugs herein described (e.g. mirtazapine, methylphenidate) should be further tested in clinical trials focused on subgroups. Lastly, objective measures, such as urinalysis, are mandatory to include in clinical trials and early treatment response and/or medication compliance should be carefully monitored and considered as predictors of success/failure.
AD - Institute of Pharmacology and Experimental Therapeutics/iCBR, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.; Neuroscience, Vision and Brain Diseases, CNC.IBILI-University of Coimbra, Coimbra, Portugal.; Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.; Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.; Institute of Pharmacology and Experimental Therapeutics/iCBR, Faculty of Medicine, University of Coimbra, Coimbra, Portugal.; Neuroscience, Vision and Brain Diseases, CNC.IBILI-University of Coimbra, Coimbra, Portugal.; Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal.; Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.
BT - Expert opinion on pharmacotherapy
C5 - Opioids & Substance Use
CP - 18
CY - England
DO - 10.1080/14656566.2019.1681970
IS - 18
JF - Expert opinion on pharmacotherapy
LA - eng
M1 - Journal Article
N2 - Introduction: Drug use related deaths are increasing and the lack of effective treatment for psychostimulants can be largely held responsible. Particularly, no pharmacotherapy is approved for methamphetamine (METH) use disorder despite decades of research. Only psychosocial interventions are clinically used, with limited long-term recovery and relapse.Areas covered: This review aims to select and describe the most relevant findings to date. Selected clinical trials were found in PubMed using the following keywords ('methamphetamine') and ('addiction' OR 'withdrawal' OR 'treatment' OR 'pharmacotherapy'). Randomized placebo-controlled trials enrolling treatment-seeking METH-dependent subjects and inherent secondary analysis were included.Expert opinion: Overall, end-of-treatment abstinence, reduced METH use or lower relapse rates were seen on METH dependent subgroups or attained significance only following post hoc analysis, irrespective of the medication tested. For example, light and heavy METH users seem to respond differently to pharmacotherapy. This together with the heterogeneous nature of the METH dependent population strongly suggests that some drugs herein described (e.g. mirtazapine, methylphenidate) should be further tested in clinical trials focused on subgroups. Lastly, objective measures, such as urinalysis, are mandatory to include in clinical trials and early treatment response and/or medication compliance should be carefully monitored and considered as predictors of success/failure.
PP - England
PY - 2019
SN - 1744-7666; 1465-6566
SP - 2273
EP - 2293
EP - 
T1 - Pharmacotherapeutic strategies for methamphetamine use disorder: mind the subgroups
T2 - Expert opinion on pharmacotherapy
TI - Pharmacotherapeutic strategies for methamphetamine use disorder: mind the subgroups
U1 - Opioids & Substance Use
U2 - 31671001
U3 - 10.1080/14656566.2019.1681970
VL - 20
VO - 1744-7666; 1465-6566
Y1 - 2019
Y2 - Dec
ER -