Researchers looking at combining two medications to treat methamphetamine disorder think their approach may be a safe and effective way to treat addicted adults.
By combining injectable naltrexone and oral bupropion, researchers within the National Institute on Drug Abuse Clinical Trials Network, part of the National Institutes of Health, have seen success in treating patients with moderate to severe methamphetamine use disorder in addition to other approaches to treatment, such as cognitive behavioral therapy and contingency management interventions.
“The opioid crisis and resulting overdose deaths in the United States are now well known, but what is less recognized is that there is a growing crisis of overdose deaths involving methamphetamine and other stimulants. However, unlike for opioids, there are currently no approved medications for treating methamphetamine use disorder,” said NIDA Director Nora D. Volkow. “This advance demonstrates that medical treatment for methamphetamine use disorder can help improve patient outcomes.”
The study, “Accelerated Development of Additive Pharmacotherapy Treatment for Methamphetamine Use Disorder,” was conducted between 2017 and 2019 at clinics across the country. Using 403 adult volunteers between 18 and 65 with moderate to severe methamphetamine use disorder, the study provided some volunteers with the naltrexone, bupropion combination while giving the other placebos. Urine samples were collected throughout the study, and a volunteer was considered successfully treated if three of four urine samples came back without traces of methamphetamine.
The study found that participants taking the drug combination were more likely to report that they had fewer cravings for the drug and greater improvements in their lives. Additionally, there were no significant adverse effects associated with the drug combination.
“Long-term methamphetamine misuse has been shown to cause diffuse changes to the brain, which can contribute to severe health consequences beyond addiction itself,” said Dr. Madhukar H. Trivedi of the University of Texas Southwestern Medical Center, Dallas, who led the trial. “The good news is that some of the structural and neurochemical brain changes are reversed in people who recover, underscoring the importance of identifying new and more effective treatment strategies.”