Premium
Sustained‐release methylphenidate in a randomized trial of treatment of methamphetamine use disorder
Author(s) -
Ling Walter,
Chang Linda,
Hillhouse Maureen,
Ang Alfonso,
Striebel Joan,
Jenkins Jessica,
Hernandez Jasmin,
Olaer Mary,
Mooney Larissa,
Reed Susan,
Fukaya Erin,
Kogachi Shan,
Alicata Daniel,
Holmes Nataliya,
Esagoff Asher
Publication year - 2014
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12608
Subject(s) - craving , medicine , methylphenidate , placebo , randomized controlled trial , methamphetamine , adverse effect , dosing , psychiatry , attention deficit hyperactivity disorder , addiction , alternative medicine , pathology
Background and Aims No effective pharmacotherapy for methamphetamine ( MA ) use disorder has yet been found. This study evaluated sustained‐release methylphenidate ( MPH‐SR ) compared with placebo ( PLA ) for treatment of MA use disorder in people also undergoing behavioral support and motivational incentives. Design This was a randomized, double‐blind, placebo‐controlled design with MPH‐SR or PLA provided for 10 weeks (active phase) followed by 4 weeks of single‐blind PLA . Twice‐weekly clinic visits, weekly group counseling ( CBT ) and motivational incentives ( MI ) for MA ‐negative urine drug screens ( UDS ) were included. Setting Treatment sites were in L os A ngeles, C alifornia ( LA ) and H onolulu, H awaii ( HH ), USA . Participants A total of 110 MA ‐dependent (via DSM‐IV ) participants ( LA = 90; HH = 20). Measurements The primary outcome measure is self‐reported days of MA use during the last 30 days of the active phase. Included in the current analyses are drug use ( UDS and self‐report), retention, craving, compliance (dosing, CBT , MI ), adverse events and treatment satisfaction. Findings No difference was found between treatment groups in self‐reported days of MA use during the last 30 days of the active phase ( P = 0.22). In planned secondary outcomes analyses, however, the MPH group had fewer self‐reported MA use days from baseline through the active phase compared with the PLA group ( P = 0.05). The MPH group also had lower craving scores and fewer marijuana‐positive UDS than the PLA group in the last 30 days of the active phase. The two groups had similar retention, other drug use, adverse events and treatment satisfaction. Conclusions Methylphenidate may lead to a reduction in concurrent methamphetamine use when provided as treatment for patients undergoing behavioral support for moderate to severe methamphetamine use disorder, but this requires confirmation.