A new treatment that combines two existing medications may provide long-sought relief for many battling methamphetamine use disorders, according to a study published tomorrow in New England Journal of Medicine.
The article, based on a multisite study funded by the National Institutes of Health (NIH), describes how it brought together an injectable drug currently used for the treatment of alcoholism and addiction. Opioid (naltrexone), and commonly prescribed antidepressant (bupropion) provided positive results in 13.6 percent of the 403 patients treated, significantly higher than the 2.5 percent response in placebo groups.
This is an important improvement as there are no longer effective treatments for methamphetamine use disorder, says Madhukar Trivedi, MD, professor of psychology at UT Southwestern and first author of the study.
It is incredibly encouraging that we have the most positive treatment outcomes ever for this dissertation. The medical field has been unable to find a cure for people with meth use disorder. “
Madhukar Trivedi, MD, First Author Study, Professor, Psychology, UT Southwestern medical center
Since both drugs are already approved by the Food and Drug Administration for other purposes, clinicians can immediately begin using them to treat patients suffering from addiction to the stimulant methamphetamine, it is important. add.
Nearly 1.9 million Americans reported using methamphetamines in 2018, according to a report next year by the Centers for Disease Control and Prevention (CDC). Deaths with psychostimulants such as methamphetamine and cocaine have skyrocketed since 2012, with more than 10,000 people dying from drug overdose including psychostimulants with potential for abuse in 2017, according to the same CDC report.
Even when it’s not fatal, “the disorder of methamphetamine use greatly affects people’s lives in many different ways,” said Trivedi, also Chief Investigator of the Great Southwest Node of the National Institute on Drug-funded Clinical Trials Network and the founding director of the UT Southwestern Center for Depression and Clinical Care Studies.
Stimulant use can also lead to high blood pressure and increased heart rate, leading to heart attack and organ failure. The use of stimulants such as methamphetamine is also associated with sleep deprivation, unbalanced judgment, and aggressive, aggravated behavior, it adds, leading to lost jobs and separated family and social ties. Over time, it can also damage neurons in the brain.
The new study “creates hope for this population and a viable drug treatment option,” Trivedi says.
Realizing that each medication was used on its own to try to treat these patients, Trivedi came up with the idea of combining the two drugs about six years ago. In the study, participants were given 380 milligrams of naltrexone every three weeks and 450 milligrams of extended-release bupropion daily.
During the placebo-controlled, double-blind, placebo-controlled study conducted at UT Southwestern, Columbia University, UCLA, Duke University School of Medicine, and four other centers – adults with moderate or severe methamphetamine use disorder who had aspired reduce or stop. the use of meth was prescribed to obtain either the drug treatment combination or placebo for six weeks.
In the second phase, 225 participants did not respond when the placebo was repeated for a second six weeks in an effort to reduce the impact of false reactions.
A positive treatment response was defined as three out of four urine samples negative for methamphetamine.
Combining results from both phases of the study, the median weight-response rate was 13.6 percent for those receiving the versatile 2.5 percent medications in the placebo group. That means there was a treatment effect of 11.1 percent once a placebo effect is reported, according to the study.
Those who received the medication combination also reported less craving for methamphetamines than those who received placebo.
The side effects of the treatment were mild or moderate and included nausea (in about a third of those receiving treatment), tremors (4.6 percent), malaise (3.7 percent), excessive sweating (7.3 percent), and decreased appetite (7.3 percent).
Trivedi, who holds Betty Jo Hay’s Distinguished Chair in Mental Health and Julie K. Hersh Chair for Depression Research and Clinical Care at UT Southwestern, says the next logical step is to evaluate the effectiveness of the treatment when used in a traditional setting clinic.
Source:
UT Southwestern Medical Center