Pharmacological approaches to methamphetamine dependence: a focused review

Authors

  • Laurent Karila,

    Corresponding author
    1. Addiction Research and Treatment Center, Paul Brousse Hospital, Paris XI University, AP-HP, CEA- INSERM U1000, Villejuif, France,
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  • Aviv Weinstein,

    1. Department of Medical Biophysics and Nuclear Medicine, Hadassah Hospital Ein Kerem, Jerusalem, Israel,
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  • Henri-Jean Aubin,

    1. Addiction Research and Treatment Center, Paul Brousse Hospital, Paris XI University, AP-HP, INSERM U669, Villejuif, France and
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  • Amine Benyamina,

    1. Addiction Research and Treatment Center, Paul Brousse Hospital, Paris XI University, AP-HP, INSERM U669, Villejuif, France and
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  • Michel Reynaud,

    1. Addiction Research and Treatment Center, Paul Brousse Hospital, Paris XI University, AP-HP, INSERM U669, Villejuif, France and
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    • *

      The authors contributed equally to this article.

  • Steven L. Batki

    1. Department of Psychiatry, University of California, San Francisco and San Francisco VA Medical Center, San Francisco, California, USA
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    • *

      The authors contributed equally to this article.


Dr Laurent Karila MD, Hôpital Universitaire Paul Brousse, C.E.R.T.A (Centre d'Enseignement, de Recherche, de Traitement des Addictions), 12 Avenue Paul Vaillant-Couturier, Villejuif 94800, France.
Tel.: + 33 1 4559 6513 or + 33 1 4559 6923
Fax: + 33 1 4559 3863
E-mail: laurent.karila@pbr.aphp.fr

Abstract

Methamphetamine dependence is a serious worldwide public health problem with major medical, psychiatric, socioeconomic and legal consequences. Various neuronal mechanisms implicated in methamphetamine dependence have suggested several pharmacological approaches. A literature search from a range of electronic databases (PubMed, EMBASE, PsycInfo, the NIDA research monograph index and the reference list of clinicaltrials.gov) was conducted for the period from January 1985 to October 2009. There were no restrictions on the identification or inclusion of studies in terms of publication status, language and design type. A variety of medications have failed to show efficacy in clinical trials, including a dopamine partial agonist (aripiprazole), GABAergic agents (gabapentin) and serotonergic agents (SSRI, ondansetron, mirtazapine). Three double-blind placebo-controlled trials using modafinil, bupropion and naltrexone have shown positive results in reducing amphetamine or methamphetamine use. Two studies employing agonist replacement medications, one with d-amphetamine and the other with methylphenidate, have also shown promise. Despite the lack of success in most studies to date, increasing efforts are being made to develop medications for the treatment of methamphetamine dependence and several promising agents are targets of further research.

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