Pharmacotherapy of methamphetamine addiction: an update.
Methamphetamine dependence is a serious public health problem worldwide for which there are no approved pharmacological treatments. Psychotherapy is still the mainstay of treatment; however, relapse rates are high. The search for effective pharmacological treatment has intensified in the last decade. This review will highlight progress in pharmacological interventions to treat methamphetamine dependence as well as explore new pharmacological targets. Published data from clinical trials for stimulant addiction were searched using PubMed and summarized, as well as highlights from a recent symposium on methamphetamine pharmacotherapy presented at the ISAM 2006 meeting, including interim analysis data from an ongoing D-amphetamine study in Australia. Early pilot data are encouraging for administering D-amphetamine and methylphenidate as treatment for heavy amphetamine users. Abilify at 15 mg/day dose increased amphetamine use in an outpatient pilot study. Sertraline, ondansetron, baclofen, tyrosine, and imipramine were ineffective in proof-of-concept studies. Development of pharmacotherapy for methamphetamine dependence is still in an early stage. Data suggesting D-amphetamine and methylphenidate as effective pharmacotherapy for methamphetamine addiction will need to be confirmed by larger trials. Preclinical data suggest that use of GVG, CB1 antagonist, and lobeline are also promising therapeutic strategies.
Elkashef
Ahmed
A
Clinical Medical Branch, Division of Pharmacotherapies and Medical Consequences of Drug Abuse, National Institute on Drug Abuse, National Institutes of Health, Department of Health and Human Services, Bethesda, MD 20892, USA. ae8a@nih.gov
Vocci
Frank
F
Hanson
Glen
G
White
Jason
J
Wickes
Wendy
W
Tiihonen
Jari
J
D014150:Antipsychotic Agents / Q000627:therapeutic use; D000068180:Aripiprazole; D016642:Bupropion / Q000627:therapeutic use; D000697:Central Nervous System Stimulants; D003913:Dextroamphetamine / Q000627:therapeutic use; D004358:Drug Therapy / Q000379:methods*; D006801:Humans; D008120:Lobeline / Q000627:therapeutic use; D008694:Methamphetamine; D008774:Methylphenidate / Q000627:therapeutic use; D009292:Narcotic Antagonists / Q000627:therapeutic use; D018722:Nicotinic Agonists / Q000627:therapeutic use; D010879:Piperazines / Q000627:therapeutic use; D015995:Prevalence; D015363:Quinolones / Q000627:therapeutic use; D012008:Recurrence; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*
D014150:Antipsychotic Agents; D000697:Central Nervous System Stimulants; D009292:Narcotic Antagonists; D018722:Nicotinic Agonists; D010879:Piperazines; D015363:Quinolones; D016642:Bupropion; D008774:Methylphenidate; D008694:Methamphetamine; D000068180:Aripiprazole; D008120:Lobeline; D003913:Dextroamphetamine