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Treatment for amphetamine withdrawal.

Steven J Shoptaw1, Uyen Kao, Keith Heinzerling

  • 1Department of Family Medicine, University of California, 10880 Wilshire Boulevard, Suite 540, Los Angeles, CA 90024, USA. sshoptaw@mednet.ucla.edu

The Cochrane Database of Systematic Reviews
|April 17, 2009
PubMed
Summary
This summary is machine-generated.

Current treatments for amphetamine withdrawal are limited, with no medication proving fully effective. While amineptine reduced discontinuation, it did not alleviate withdrawal symptoms or craving.

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Area of Science:

  • Pharmacology and Addiction Medicine
  • Clinical Trials and Evidence-Based Practice
  • Neuroscience of Substance Use Disorders

Background:

  • Amphetamine withdrawal is a prevalent issue with significant relapse potential, often driven by intense craving.
  • Current clinical practices frequently employ medications developed for cocaine withdrawal, despite differing drug properties.
  • Limited research exists on effective treatments specifically for amphetamine withdrawal.

Purpose of the Study:

  • To evaluate the efficacy of pharmacological and psychosocial treatments for amphetamine withdrawal.
  • To assess the impact of treatments on discontinuation rates, global state, withdrawal severity, and craving.

Main Methods:

  • Systematic review of randomized controlled trials and clinical trials published between 1966 and 2008.
  • Searches conducted across MEDLINE, CINAHL, PsycINFO, and the Cochrane Central Register of Controlled Trials (CENTRAL).
  • Data extraction focused on intention-to-treat analyses, using Relative Risk and Weighted Mean Difference for outcome assessment.

Main Results:

  • Four trials involving 125 participants met the inclusion criteria.
  • Amineptine demonstrated a significant reduction in discontinuation rates and improved clinical presentation versus placebo, but did not impact withdrawal symptoms or craving.
  • Mirtazapine's effectiveness was unclear; one study suggested reduced hyperarousal and anxiety, while another found no benefit over placebo for retention or withdrawal symptoms.

Conclusions:

  • No medication is currently established as effective for treating amphetamine withdrawal.
  • Amineptine showed limited benefits in reducing discontinuation but is unavailable due to abuse concerns.
  • Further research should investigate medications targeting neurotransmitter systems (dopamine, norepinephrine, serotonin) for amphetamine withdrawal.