Efficacy and safety of psychostimulants for amphetamine and methamphetamine use disorders: a systematic review and meta-analysis.
Efficacy and safety of psychostimulants for amphetamine and methamphetamine use disorders: a systematic review and meta-analysis.
复制标题
心理刺激物对苯丙胺和甲基苯丙胺使用障碍的功效和安全性：系统评价和荟萃分析。
DOI：
10.1186/s13643-016-0370-x
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发表时间：
2016-11-14
影响因子：
3.7
通讯作者：
Samaan Z
中科院分区：
文献类型：
--
作者：
Bhatt M;Zielinski L;Baker-Beal L;Bhatnagar N;Mouravska N;Laplante P;Worster A;Thabane L;Samaan Z
苯丙胺和甲基苯丙胺吸毒病症与严重的健康和社会后果有关。尚未批准用于治疗这些疾病的药物治疗。精神兴奋剂可以作为维持类疗法，用于管理这些患者的物质使用。本研究的目的是评价文献检查的有效性和安全性的精神兴奋剂药物，以增加戒断和治疗保持与苯丙胺和甲基苯丙胺使用障碍的患者。我们检索了MEDLINE、EMBASE、PsycInfo、科克伦中心和CINAHL，从开始到2016年8月。研究选择、数据提取和偏差风险评估由两名评审员独立进行。我们进行了荟萃分析，以提供纳入试验的汇总汇总估计值，并根据PRISMA指南报告审查结果。我们确定并选择了17项研究，1387名受试者。各试验的结果报告不一致，由于偏倚和间接性的高风险，证据的总体质量非常低。对5项试验（642名参与者）的荟萃分析发现，精神兴奋剂对研究结束时的禁欲没有影响（比值比= 0.97，95%置信区间0.65至1.45）。此外，来自14项研究（1184名参与者）的汇总估计值显示，精神兴奋剂对治疗保留没有影响（比值比= 1.20，95%置信区间= 0.91至1.58）。根据试验的定性报告，干预组和安慰剂组之间严重不良事件的发生率没有差异。定量分析表明，精神兴奋剂对持续戒酒或治疗保持没有影响。我们还确定了在这一研究领域进行更严格的研究的必要性，临床医生和患者的重要成果。本文的在线版本（doi：10.1186/s13643-016-0370-x）包含补充材料，可供授权用户使用。
Amphetamine and methamphetamine use disorders are associated with severe health and social consequences. No pharmacological therapy has been approved for the treatment of these disorders. Psychostimulants can act as maintenance-like therapies for managing substance use among these patients. The aim of this study is to evaluate the literature examining the efficacy and safety of psychostimulant agents for increasing abstinence and treatment retention among patients with amphetamine and methamphetamine use disorders. We searched MEDLINE, EMBASE, PsycInfo, Cochrane Central, and CINAHL from inception to August 2016. Selection of studies, data extraction, and risk of bias assessment were conducted independently by two reviewers. We conducted meta-analyses to provide a pooled summary estimate for included trials and report the review according to PRISMA guidelines. We identified and selected 17 studies with 1387 participants. Outcome reporting across trials was inconsistent, and the overall quality of evidence was very low due to high risk of bias and indirectness. A meta-analysis of five trials (642 participants) found no effect of psychostimulants for end-of-study abstinence (odds ratio = 0.97, 95% confidence interval 0.65 to 1.45). Additionally, the pooled estimate from 14 studies (1184 participants) showed no effect of psychostimulants for treatment retention (odds ratio = 1.20, 95% confidence interval = 0.91 to 1.58). The incidence of serious adverse events did not differ between intervention and placebo groups based on qualitative reports from trials. Quantitative analyses showed no effect of psychostimulants for sustained abstinence or treatment retention. We also identified the need for more rigorous studies in this research area with clinician and patient important outcomes. The online version of this article (doi:10.1186/s13643-016-0370-x) contains supplementary material, which is available to authorized users.