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Updated: May 27, 2026

A General Method for Evaluating Deep Brain Stimulation Effects on Intravenous Methamphetamine Self-Administration
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Published on: January 22, 2016

Mirtazapine to reduce methamphetamine use: a randomized controlled trial.

Grant N Colfax1, Glenn-Milo Santos, Moupali Das

  • 1San Francisco Department of Public Health, San Francisco, CA 94102, USA. grant.colfax@sfdph.org

Archives of General Psychiatry
|November 9, 2011
PubMed
Summary

Mirtazapine reduced methamphetamine use and sexual risk behaviors in men who have sex with men (MSM) in a 12-week trial. This finding offers a potential new treatment for methamphetamine dependence.

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Area of Science:

  • Clinical Medicine
  • Psychiatry
  • Addiction Medicine

Background:

  • No approved pharmacologic treatments for methamphetamine dependence currently exist.
  • Methamphetamine use is linked to high morbidity and exacerbates the HIV epidemic among men who have sex with men (MSM).

Purpose of the Study:

  • To investigate the efficacy of mirtazapine in reducing methamphetamine use among actively using MSM.
  • To assess the impact of mirtazapine on sexual risk behaviors in this population.

Main Methods:

  • A 12-week, double-blind, randomized, placebo-controlled trial involving 60 methamphetamine-dependent, sexually active MSM.
  • Participants received daily oral mirtazapine (30 mg) or placebo, alongside weekly substance use counseling.
  • Primary outcome was reduction in methamphetamine-positive urine tests; secondary outcomes included medication adherence and sexual risk behavior.

Main Results:

  • Mirtazapine significantly reduced methamphetamine-positive urine tests compared to placebo (relative risk, 0.57; P=.02).
  • The number needed to treat for a negative weekly urine test was 3.1.
  • Mirtazapine use was associated with significant decreases in various sexual risk behaviors, with no significant difference in adverse events between groups.

Conclusions:

  • Mirtazapine, when added to substance use counseling, effectively decreases methamphetamine use in active users.
  • The study suggests mirtazapine may also reduce sexual risk behaviors among MSM with methamphetamine dependence.
  • Despite low to moderate adherence, mirtazapine demonstrated clinical benefits, highlighting its potential as a treatment option.