Sustained-release methylphenidate in a randomized trial of treatment of methamphetamine use disorder.
OBJECTIVE
No effective pharmacotherapy for methamphetamine (MA) use disorder has yet been found. This study evaluated sustained-release methylphenidate (MPH-SR) compared with placebo (PLA) for treatment of MA use disorder in people also undergoing behavioral support and motivational incentives.


METHODS
This was a randomized, double-blind, placebo-controlled design with MPH-SR or PLA provided for 10 weeks (active phase) followed by 4 weeks of single-blind PLA. Twice-weekly clinic visits, weekly group counseling (CBT) and motivational incentives (MI) for MA-negative urine drug screens (UDS) were included.


METHODS
Treatment sites were in Los Angeles, California (LA) and Honolulu, Hawaii (HH), USA.


METHODS
A total of 110 MA-dependent (via DSM-IV) participants (LA = 90; HH = 20).


METHODS
The primary outcome measure is self-reported days of MA use during the last 30 days of the active phase. Included in the current analyses are drug use (UDS and self-report), retention, craving, compliance (dosing, CBT, MI), adverse events and treatment satisfaction.


RESULTS
No difference was found between treatment groups in self-reported days of MA use during the last 30 days of the active phase (P = 0.22). In planned secondary outcomes analyses, however, the MPH group had fewer self-reported MA use days from baseline through the active phase compared with the PLA group (P = 0.05). The MPH group also had lower craving scores and fewer marijuana-positive UDS than the PLA group in the last 30 days of the active phase. The two groups had similar retention, other drug use, adverse events and treatment satisfaction.


CONCLUSIONS
Methylphenidate may lead to a reduction in concurrent methamphetamine use when provided as treatment for patients undergoing behavioral support for moderate to severe methamphetamine use disorder, but this requires confirmation.
Integrated Substance Abuse Programs, University of California, Los Angeles, Los Angeles, CA, USA.
Walter
W
Ling
Linda
L
Chang
Maureen
M
Hillhouse
Alfonso
A
Ang
Joan
J
Striebel
Jessica
J
Jenkins
Jasmin
J
Hernandez
Mary
M
Olaer
Larissa
L
Mooney
Susan
S
Reed
Erin
E
Fukaya
Shannon
S
Kogachi
Daniel
D
Alicata
Nataliya
N
Holmes
Asher
A
Esagoff
D000328:Adult; D019969:Amphetamine-Related Disorders / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000627:therapeutic use*; D003692:Delayed-Action Preparations; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006254:Hawaii; D006801:Humans; D015141:Los Angeles; D008297:Male; D008774:Methylphenidate / Q000627:therapeutic use*; D016896:Treatment Outcome
D000697:Central Nervous System Stimulants; D003692:Delayed-Action Preparations; D008774:Methylphenidate
Methamphetamine; RCT; methamphetamine use disorders; methylphenidate; randomized clinical trial; treatment