title: Estimating the intake of abused methamphetamines using experimenter-administered deuterium labeled R-methamphetamine: selection of the R-methamphetamine dose.
abstract: All addictive drugs produce tolerance and addicts compensate by increasing drug exposure. Thus, the quantity of illicit drug ingested is related to the severity of addiction. Unfortunately, there are no objective methods to estimate intake for most addictive drugs. Using experimenter-administered doses of deuterium-labeled R-methamphetamine (R-[-]-MA-d3), we have developed a method to estimate the amount of abused methamphetamine intake in addicts enrolled in clinical trials. This study assessed the pharmacokinetics, pharmacodynamics, and tolerability of single oral doses of R-MA in healthy adults to select a dose of R-MA-d3 to be used as a biomarker for estimation the amount of methamphetamine abuse. This was a five-session randomized, double-blind, placebo-controlled, balanced crossover study in eight subjects. Oral R-(-)-MA was dosed at 0 mg, 1 mg, 2.5 mg, 5 mg, or 10 mg; bioavailability was estimated by slow intravenous dosing (30 minutes) of 2.5 mg R-(-)-MA-d3 given with the 2.5 mg R-(-)-MA oral dose condition. Pharmacokinetic and pharmacodynamic measures were obtained. No serious adverse events occurred during the study and all doses of R-MA were well tolerated. Linear pharmacokinetics was observed within our oral dose range of 1 to 10 mg. Complete bioavailability and pharmacologic inactivity were found for all oral doses. These characteristics indicate the advantage of using a small oral R-(-)-MA-d3 dose as a biomarker to estimate exposure to abused methamphetamine. Based on these results, 5 mg R-(-)-MA-d3 has been selected as the biomarker dose in future studies. Preliminary findings from our study indicate that experimenter-administered oral R-(-)-MA-d3 may allow estimation of abused methamphetamine intake and exposure. Knowledge of the quantity of methamphetamine intake may allow better estimation of disease severity and treatment efficacy. Experience gained from this study also can be applied to the management of other drug dependence problems such as cocaine, cannabinoid, and opiate addiction.
authors.affiliation: Addiction Pharmacology Research Laboratory, California Pacific Medical Center Research Institute, San Francisco, CA, USA. lilx@cpmcri.org
authors.forename: Linghui
authors.initials: L
authors.lastname: Li
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Lopez
authors.forename: Gantt P
authors.initials: GP
authors.lastname: Galloway
authors.forename: Matthew J
authors.initials: MJ
authors.lastname: Baggott
authors.forename: Tom
authors.initials: T
authors.lastname: Everhart
authors.forename: John
authors.initials: J
authors.lastname: Mendelson
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D019969:Amphetamine-Related Disorders / Q000378:metabolism*; D019540:Area Under Curve; D015415:Biomarkers; D001794:Blood Pressure / Q000187:drug effects; D001831:Body Temperature / Q000187:drug effects; D002492:Central Nervous System Depressants / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics*; D018592:Cross-Over Studies; D003903:Deuterium; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006207:Half-Life; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D007275:Injections, Intravenous; D007553:Isotope Labeling; D008297:Male; D008694:Methamphetamine / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics*; D008875:Middle Aged; D010100:Oxygen / Q000097:blood; D055815:Young Adult
chemical_list: D015415:Biomarkers; D002492:Central Nervous System Depressants; D008694:Methamphetamine; D003903:Deuterium; D010100:Oxygen