Randomized, placebo-controlled trial of bupropion for the treatment of methamphetamine dependence
Randomized, placebo-controlled trial of bupropion for the treatment of methamphetamine dependence
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DOI：
10.1016/j.drugalcdep.2008.03.010
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发表时间：
2008-08-01
影响因子：
4.2
通讯作者：
Ling, Walter
中科院分区：
文献类型：
--
作者：
Shoptaw, Steven;Heinzerling, Keith G.;Ling, Walter
目的：比较安非他酮与安慰剂减少甲基苯丙胺（MA）使用，增加保留，并降低抑郁症状和MA渴望的严重程度。次要目标比较安非他酮安慰剂减少吸烟MA dependent participants.Methods：经过2周，非药物基线筛选期，73治疗寻求MA依赖参与者被随机分配到安非他酮缓释（150毫克，每日两次; N=36）或安慰剂（每日两次; N=37）12周的双盲条件下。参加者每周三次诊所提供尿液样本分析MA代谢物，完成研究措施和评估，并接受应急管理和每周认知行为therapeutic sessions.Results：安非他酮相对于安慰剂对MA使用验证尿液药物筛选，减少抑郁症状或MA的渴望，或研究保留的严重程度没有统计学意义的影响。在事后分析中，在基线期间使用MA较轻（0-2次MA阳性尿液）但不较重（3-6次MA阳性尿液）的参与者中，安非他酮治疗对MA使用的影响具有统计学显著性（OR = 2.81，95%CI = 1.61-4.93，轻度使用者中无安非他酮的一周p < 0.001）。安非他酮治疗也与吸烟显着减少，几乎每天5支香烟（p = 0.0002）。结论：安非他酮是没有更有效的比安慰剂在减少MA的使用在计划的分析，虽然安非他酮确实减少吸烟。安非他酮在基线轻度MA使用者中的作用的事后结果表明，安非他酮对轻度MA使用者的进一步评价是必要的。(C)2008爱思唯尔爱尔兰有限公司保留所有权利。
Objective: To compare bupropion to placebo for reducing methamphetamine (MA) use, increasing retention, and reducing the severity of depressive symptoms and MA-cravings. A secondary objective compared bupropion to placebo for reducing cigarette smoking among MA dependent participants.Methods: Following a 2-week, non-medication baseline screening period, 73 treatment-seeking MA dependent participants were randomly assigned to bupropion sustained release (150 mg twice daily; N=36) or placebo (twice daily; N=37) for 12-weeks under double-blind conditions. Participants attended clinic thrice weekly to provide urine samples analyzed for MA-metabolite, to complete research measures and assessments, and to receive contingency management and weekly cognitive behavioral therapy sessions.Results: There were no statistically significant effects for bupropion relative to placebo on MA use verified by urine drug screens, for reducing the severity of depressive symptoms or MA-cravings, or on study retention. In a post hoc analysis, there was a statistically significant effect of bupropion treatment on MA use among participants with lighter (0-2 MA-positive urines), but not heavier (3-6 MA-positive urines) MA use during baseline (OR = 2.81, 95% CI = 1.61-4.93, p < 0.001 for MA-free week with bupropion among light users). Bupropion treatment was also associated with significantly reduced cigarette smoking, by almost five cigarettes per day (p = 0.0002).Conclusion: Bupropion was no more effective than placebo in reducing MA use in planned analyses, though bupropion did reduce cigarette smoking. Post hoc findings of an effect for bupropion among baseline light, but not heavy, MA users suggests further evaluation of bupropion for light-MA users is warranted. (C) 2008 Elsevier Ireland Ltd. All rights reserved.