| Agents demonstrating some promise |
| methylphenidate 54 mg/day (35) |
Three-arm randomized double-blind design (methylphenidate, aripiprazole, placebo); N=53, 20 weeks of treatment, injection use history for all participants; urine samples twice weekly |
Patients in methyphenidate condition were less likely to provide amphetamine-positive samples during course of treatment (odds ratio=.46; p=.008) |
Study was terminated prematurely due to iatrogenic effect of aripiprazole. A trial of methylphenidate for MA depenedence is ongoing |
| bupropion 150 mg twice daily (55) |
Randomized double-blind placebo-controlled design; N=151, 12 weeks of treatment; urine samples thrice weekly |
No group difference for primary outcome of probability of MA-free week; subgroup of modest users (fewer than 19 days use in past month) benefitted from bupropion in terms of probability of MA-free week (p=.03) |
Some suggestion that men may benefit from bupropion while women receive no benefit |
| bupropion 150 mg twice daily (56) |
Randomized double-blind placebo-controlled design; N=73, 12 weeks of treatment; urine samples thrice weekly |
No group difference for primary outcome of probability of MA-free week; subgroup of light users during 2-week baseline period benefitted from bupropion in terms of probability of MA-free week (odds ratio=2.81; p<.001) |
Very similar pattern of results to Elkashef et al. (55) suggesting that among light users, bupropion may be efficacious |
| mirtazapine 30 mg/day (68) |
Randomized double-blind placebo-controlled design; N=60, sample composed exclusively of men who have sex with men, 12 weeks of treatment; urine samples once weekly |
Patients in mirtazapine condition were less likely to provide methamphetamine-positive samples during course of treatment (relative risk=.57; p=.02) |
Unusually high retention in this study. A replication of these findings is underway. An underpowered randomized trial assessed the efficacy of mirtazapine for managining MA-withdrawal reported null findings (69) |
| naltrexone capsules 50 mg/day (28) |
Randomized double-blind placebo-controlled design; N=80, 12 weeks of treatment; urine samples twice weekly |
Patients in naltrexone group featured more amphetamine-free urine samples (p<.05) |
Medication adherence was 63% and adherence was strongly related to treatment outcomes |
| naltrexone implant (Prodetoxon) |
Randomized double-blind placebo-controlled design; N=100, sample composed patients with concurrent amphetamine and opioid dependence; 10 weeks of treatment, urine samples collected once weekly |
The proportion of drug-free urine samples was 38% in the naltrexone group and 16% in the placebo group (p=0.01). Retention was 52% in naltexone condition and 28% in placebo condition (p=.01) |
Relevance for primary users of amphetamine are unclear as naltrexone did not produce more amphetamine-negative urine samples specifically, when compared with placebo |
| Medications with possible iatrogenic effects |
| aripiprazole 15 mg/day |
Three-arm randomized design (methylphenidate, aripiprazole, placebo); N=53, 20 weeks of treatment, injection use history for all participants; urine samples collected twice weekly |
Patients in aripiprazole condition were more likely to provide amphetamine-positive samples during course of treatment (odds ratio=3.77; p=.003) |
Study was terminated prematurely due to iatrogenic effect of aripiprazole. Subsequent findings with aripiprazole have been discouraging |
| sertaline 50 mg twice daily |
Four-arm randomized double-blind (with respect to medication condition) placebo controlled trial. 2×2, sertraline vs. placebo, contingency management vs. no contingency management); 12 weeks of treatment, urine samples collected thrice weekly |
No main effect was observed for sertraline on MA use; however, the sertraline-only condition featured more MA-positive samples (p<.05) and poorer retention (p<.05) |
Taken together with other negative findings for fluoxetine and paroxetine, SSRIs appear to be poor candidates for MA pharmacotherapy |
