A comparison of aripiprazole, methylphenidate, and placebo for amphetamine dependence.
OBJECTIVE
Problems related to illegal amphetamine use have become a major public health issue in many developed countries. To date, evidence on the effectiveness of psychosocial treatments has remained modest, and no pharmacotherapy has proven effective for amphetamine dependence.


METHODS
Individuals meeting DSM-IV criteria for intravenous amphetamine dependence (N=53) were randomly assigned to receive aripiprazole (15 mg/day), slow-release methylphenidate (54 mg/day), or placebo for 20 weeks. The study was terminated prematurely due to unexpected results of interim analysis. An intention-to-treat analysis was used. The primary outcome measure was the proportion of amphetamine-positive urine samples.


RESULTS
Patients allocated to aripiprazole had significantly more amphetamine-positive urine samples than patients in the placebo group (odds ratio=3.77, 95% CI=1.55-9.18), whereas patients who received methylphenidate had significantly fewer amphetamine-positive urine samples than patients who had received placebo (odds ratio=0.46, 95% CI=0.26-0.81).


CONCLUSIONS
Methylphenidate is an effective treatment for reducing intravenous drug use in patients with severe amphetamine dependence.
Tiihonen
Jari
J
Department of Forensic Psychiatry, University of Kuopio, and the Department of Psychiatry, Helsinki University Hospital, Finland. jari.tiihonen@niuva.fi
Kuoppasalmi
Kimmo
K
Föhr
Jaana
J
Tuomola
Pekka
P
Kuikanmäki
Outi
O
Vorma
Helena
H
Sokero
Petteri
P
Haukka
Jari
J
Meririnne
Esa
E
D000328:Adult; D000661:Amphetamine / Q000652:urine; D019969:Amphetamine-Related Disorders / Q000188:drug therapy* / Q000652:urine; D000068180:Aripiprazole; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D010879:Piperazines / Q000627:therapeutic use*; D010919:Placebos; D015363:Quinolones / Q000627:therapeutic use*; D012720:Severity of Illness Index; D015813:Substance Abuse Detection; D015819:Substance Abuse, Intravenous / Q000188:drug therapy* / Q000652:urine; D016896:Treatment Outcome
D010879:Piperazines; D010919:Placebos; D015363:Quinolones; D008774:Methylphenidate; D000068180:Aripiprazole; D000661:Amphetamine