TY - JOUR
KW - Acupuncture
KW - Anticonvulsants/therapeutic use
KW - Antidepressive Agents/therapeutic use
KW - Antipsychotic Agents/therapeutic use
KW - Central Nervous System Stimulants/therapeutic use
KW - cognitive behavioral therapy
KW - Dopamine Agonists/therapeutic use
KW - Humans
KW - Substance-Related Disorders/drug therapy/pathology/therapy
AU - C. Ronsley
AU - S. Nolan
AU - R. Knight
AU - K. Hayashi
AU - J. Klimas
AU - A. Walley
AU - E. Wood
AU - N. Fairbairn
A1 - 
AB - AIMS: Stimulant use disorder contributes to a substantial worldwide burden of disease, although evidence-based treatment options are limited. This systematic review of reviews aims to: (i) synthesize the available evidence on both psychosocial and pharmacological interventions for the treatment of stimulant use disorder; (ii) identify the most effective therapies to guide clinical practice, and (iii) highlight gaps for future study. METHODS: A systematic database search was conducted to identify systematic reviews and meta-analyses. Eligible studies were those that followed standard systematic review methodology and assessed randomized controlled trials focused on the efficacy of interventions for stimulant use disorder. Articles were critically appraised using an assessment tool adapted from Palmeteer et al. and categorized for quality as 'core' or 'supplementary' reviews. Evidence from the included reviews were further synthesized according to pharmacological or non-pharmacological management themes. RESULTS: Of 476 identified records, 29 systematic reviews examining eleven intervention modalities were included. The interventions identified include: contingency management, cognitive behavioural therapy, acupuncture, antidepressants, dopamine agonists, antipsychotics, anticonvulsants, disulfiram, opioid agonists, N-Acetylcysteine, and psychostimulants. There was sufficient evidence to support the efficacy of contingency management programs for treatment of stimulant use disorder. Psychostimulants, n-acetylcysteine, opioid agonist therapy, disulfiram and antidepressant pharmacological interventions were found to have insufficient evidence to support or discount their use. Results of this review do not support the use of all other treatment options. CONCLUSIONS: The results of this review supports the use of contingency management interventions for the treatment of stimulant use disorder. Although evidence to date is insufficient to support the clinical use of psychostimulants, our results demonstrate potential for future research in this area. Given the urgent need for effective pharmacological treatments for stimulant use disorder, high-quality primary research focused on the role of psychostimulant medications for the treatment of stimulant use disorder is needed.
AD - British Columbia Centre on Substance Use, Vancouver, BC, Canada.; Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada.; British Columbia Centre on Substance Use, Vancouver, BC, Canada.; Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada.; British Columbia Centre on Substance Use, Vancouver, BC, Canada.; Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada.; British Columbia Centre on Substance Use, Vancouver, BC, Canada.; Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada.; British Columbia Centre on Substance Use, Vancouver, BC, Canada.; School of Medicine, University College Dublin, Belfield, Dublin, Ireland.; Department of General Internal Medicine, Boston Medical Center, Boston, MA, United States of America.; Boston University School of Medicine, Boston, MA, United States of America.; British Columbia Centre on Substance Use, Vancouver, BC, Canada.; Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada.; British Columbia Centre on Substance Use, Vancouver, BC, Canada.; Department of Medicine, University of British Columbia, St. Paul's Hospital, Vancouver, BC, Canada.
BT - PloS one
C5 - Key & Foundational; Opioids & Substance Use
CP - 6
DO - 10.1371/journal.pone.0234809
IS - 6
JF - PloS one
LA - eng
M1 - Journal Article
N2 - AIMS: Stimulant use disorder contributes to a substantial worldwide burden of disease, although evidence-based treatment options are limited. This systematic review of reviews aims to: (i) synthesize the available evidence on both psychosocial and pharmacological interventions for the treatment of stimulant use disorder; (ii) identify the most effective therapies to guide clinical practice, and (iii) highlight gaps for future study. METHODS: A systematic database search was conducted to identify systematic reviews and meta-analyses. Eligible studies were those that followed standard systematic review methodology and assessed randomized controlled trials focused on the efficacy of interventions for stimulant use disorder. Articles were critically appraised using an assessment tool adapted from Palmeteer et al. and categorized for quality as 'core' or 'supplementary' reviews. Evidence from the included reviews were further synthesized according to pharmacological or non-pharmacological management themes. RESULTS: Of 476 identified records, 29 systematic reviews examining eleven intervention modalities were included. The interventions identified include: contingency management, cognitive behavioural therapy, acupuncture, antidepressants, dopamine agonists, antipsychotics, anticonvulsants, disulfiram, opioid agonists, N-Acetylcysteine, and psychostimulants. There was sufficient evidence to support the efficacy of contingency management programs for treatment of stimulant use disorder. Psychostimulants, n-acetylcysteine, opioid agonist therapy, disulfiram and antidepressant pharmacological interventions were found to have insufficient evidence to support or discount their use. Results of this review do not support the use of all other treatment options. CONCLUSIONS: The results of this review supports the use of contingency management interventions for the treatment of stimulant use disorder. Although evidence to date is insufficient to support the clinical use of psychostimulants, our results demonstrate potential for future research in this area. Given the urgent need for effective pharmacological treatments for stimulant use disorder, high-quality primary research focused on the role of psychostimulant medications for the treatment of stimulant use disorder is needed.
PY - 2020
SN - 1932-6203; 1932-6203
T1 - Treatment of stimulant use disorder: A systematic review of reviews
T2 - PloS one
TI - Treatment of stimulant use disorder: A systematic review of reviews
U1 - Key & Foundational; Opioids & Substance Use
U2 - 32555667
U3 - 10.1371/journal.pone.0234809
VL - 15
VO - 1932-6203; 1932-6203
Y1 - 2020
Y2 - Jun 18
ER -