title: Randomized, placebo-controlled trial of bupropion in methamphetamine-dependent participants with less than daily methamphetamine use.
abstract: OBJECTIVE
  Two previous randomized trials found an effect for bupropion in reducing methamphetamine use in the subgroup with lower frequency of methamphetamine use at baseline. This study aimed to replicate these results by comparing bupropion versus placebo in methamphetamine-dependent participants with less than daily methamphetamine use at baseline.
  
  
  METHODS
  Methamphetamine-dependent volunteers reporting methamphetamine use on ≤29 of past 30 days were randomized to bupropion 150 mg twice daily (n = 41) or placebo (n = 43) and out-patient counseling for 12 weeks. The primary outcome was the proportion achieving end-of-treatment (EOT) methamphetamine abstinence (weeks 11 and 12) for bupropion versus placebo. A post-hoc analysis compared EOT abstinence by medication adherence assessed via plasma bupropion/hydroxybupropion level.
  
  
  RESULTS
  There was no significant difference in EOT abstinence between bupropion (29%, 12 of 41) and placebo (14%, six of 43; P = 0.087). Among participants receiving bupropion, EOT abstinence was significantly higher in participants assessed as medication adherent by plasma bupropion/hydroxybupropion levels (54%, seven of 13) compared to non-adherent participants (18%, five of 28; P = 0.018). Medication adherence by plasma levels was low (32%).
  
  
  CONCLUSIONS
  Bupropion may be efficacious for reducing methamphetamine in people with less than daily baseline methamphetamine use, but the evidence remains inconclusive.
authors.affiliation: University of California Los Angeles (UCLA) Department of Family Medicine, UCLA Center for Behavioral and Addiction Medicine, Los Angeles, CA, USA.
authors.forename: Keith G
authors.initials: KG
authors.lastname: Heinzerling
authors.forename: Aimee-Noelle
authors.initials: AN
authors.lastname: Swanson
authors.forename: Timothy M
authors.initials: TM
authors.lastname: Hall
authors.forename: Yi
authors.initials: Y
authors.lastname: Yi
authors.forename: Yingnian
authors.initials: Y
authors.lastname: Wu
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Shoptaw
mesh_terms: D000328:Adult; D019969:Amphetamine-Related Disorders / Q000188:drug therapy*; D016642:Bupropion / Q000097:blood / Q000627:therapeutic use*; D018765:Dopamine Uptake Inhibitors / Q000097:blood / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008694:Methamphetamine / Q000008:administration & dosage*; D008875:Middle Aged; D016896:Treatment Outcome; D016903:Drug Monitoring
chemical_list: D018765:Dopamine Uptake Inhibitors; D016642:Bupropion; D008694:Methamphetamine
keywords: Bupropion; clinical trial; medication non-adherence; methamphetamine; pharmacotherapy; placebo