title: Effects of oral methamphetamine on cocaine use: a randomized, double-blind, placebo-controlled trial.
abstract: BACKGROUND
  No medication is currently approved for the treatment of cocaine dependence, but several preclinical and clinical reports suggest agonist-like medications, e.g., amphetamine analogues, may be a productive strategy for medication development.
  
  
  OBJECTIVE
  This current proof-of-concept study sought to evaluate the safety, tolerability, and effectiveness of methamphetamine as a candidate treatment for cocaine dependence.
  
  
  METHODS
  A randomized, double-blind, placebo-controlled study served to evaluate three treatment conditions in 82 cocaine-dependent individuals: (1) placebo (0mg, 6x/day; n=27), (2) immediate release (IR) methamphetamine (5mg, 6x/day; n=30), (3) sustained release (SR) methamphetamine (30 mg first pill, 1x/day; 0mg 5x/day; n=25). The study employed a sequential, two-phase design (i.e., 4 weeks of medication and counseling followed by 4 weeks of medication/counseling plus a contingency management procedure).
  
  
  RESULTS
  Both preparation forms of methamphetamine were well-tolerated, with similar retention to placebo (0mg, 33%; 30 mg IR, 30%, 30 mg SR, 32%). Methamphetamine SR was associated with decreased sleep and increased weight loss. Medication adherence rates were high for the first dose of the day (95%), while adherence for subsequent capsules was lower. Those in the SR condition exhibited consistently lower rates of cocaine-positive urine samples (0mg, 60%; 30 mg IR, 66%; 30 mg SR, 29%), p<0.0001, and reported the greatest reduction in craving for cocaine, p<0.05.
  
  
  CONCLUSIONS
  SR methamphetamine significantly reduced cocaine use and craving. Additional research is warranted to develop and evaluate agonist-like medications that may effectively treat cocaine dependence.
authors.affiliation: Department of Psychiatry, University of Minnesota, Minneapolis, MN 55414, USA. moon0078@umn.edu
authors.forename: Marc E
authors.initials: ME
authors.lastname: Mooney
authors.forename: David V
authors.initials: DV
authors.lastname: Herin
authors.forename: Joy M
authors.initials: JM
authors.lastname: Schmitz
authors.forename: Nidal
authors.initials: N
authors.lastname: Moukaddam
authors.forename: Charles E
authors.initials: CE
authors.lastname: Green
authors.forename: John
authors.initials: J
authors.lastname: Grabowski
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000627:therapeutic use*; D019970:Cocaine-Related Disorders / Q000523:psychology / Q000534:rehabilitation*; D003692:Delayed-Action Preparations; D004311:Double-Blind Method; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008694:Methamphetamine / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D012256:Riboflavin; D015813:Substance Abuse Detection; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants; D003692:Delayed-Action Preparations; D008694:Methamphetamine; D012256:Riboflavin