By Paul McClure
December 27, 2024
An existing ADHD medication can help people quit methamphetamine
Depositphotos
View 1 Images
New research has found that an existing ADHD medication greatly reduced the number of days people with a methamphetamine dependence used the drug. With no current drug treatment to assist people in getting off meth, the study’s findings are promising.
For those with an amphetamine-type stimulant use disorder (ATSUD), their drug misuse negatively impacts health and everyday functioning. According to the United Nations’ Online World Drug Report 2023, the use of amphetamine-type stimulants, which includes methamphetamine, has increased in most countries over the past decade. As has the number of deaths related to amphetamine use.
More Stories
Military
Watch the deployment of the world’s fastest tank-carrying floating bridge
Military
China unveils new sixth-generation stealth fighter jets
While drugs like methadone and buprenorphine are used to treat opioid dependence, there’s no effective drug treatment for ATSUD. However, a new Australian study may have identified one that’s already on the market and is being used to treat ADHD.
“There is currently no pharmacotherapy approved for treating methamphetamine dependence,” said Professor Nadine Ezard, Director of the National Center for Clinical Research on Emerging Drugs (NCCRED) in Australia and the study’s lead author. “While further research is needed, experienced clinicians could consider off-label prescription of lisdexamfetamine, with close monitoring of risks and benefits in line with current guidelines for psychostimulants, for people with methamphetamine use disorder.”
Lisdexamfetamine is a relatively new central nervous system stimulant prescribed for attention deficit hyperactivity disorder (ADHD) and binge eating disorder (BED). Sold as Vyvanse or Elvanse, it’s one of a class of drugs called psychostimulants that works by improving the way parts of the brain communicate with one another. The researchers considered lisdexamfetamine to be a good candidate because it’s a prodrug, meaning it’s inactive until after it’s taken and is metabolized into active dexamphetamine. Being a prodrug of dexamphetamine, it’s less likely to be misused.
To test the drug’s safety and effectiveness as a treatment to reduce methamphetamine use, they recruited 164 adults with meth dependence who’d reported at least 14 days of use out of the previous 28 days. Participants were randomly allocated to receive oral lisdexamfetamine daily for 15 weeks or an identically matched placebo. They were followed up for four weeks after treatment. Treatment included a one-week induction period, taking 150 mg a day, then 12 weeks of a 250 mg-a-day maintenance dose, followed by a two-week tapering period (150 mg daily for one week; 50 mg daily for one week). The primary measure was the difference between the treatment and placebo groups’ self-reported meth use at the end of the 12-week maintenance period.
Overall, the participants who received lisdexamfetamine reported 8.8 fewer days of methamphetamine use on average during the maintenance phase than the placebo group. The treatment group also reported 2.9 times higher rates of treatment effectiveness and 3.8 times higher treatment satisfaction. The effects were strongest at the beginning of the trial.
“While the beneficial effect waned towards the end of the treatment period, exploring the characteristics of ‘early responders’ in our study will be useful to understand who may benefit most from agonist therapies,” Ezard said.
Agonist therapies are treatments like those mentioned above – methadone and buprenorphine for opioid dependence – that help prevent withdrawal and reduce cravings.
The dose of lisdexamfetamine given to study participants was high. For adults and children with ADHD, the starting dose is 30 mg a day, which is slowly increased to a maximum of 70 mg/day as needed. During the maintenance phase of the present trial, the participants were taken 250 mg/day, about 3.6 times the dose given for ADHD. Importantly, there were no unexpected safety concerns at this dose. Adverse events were mostly mild-to-moderate, with nausea the only side effect that occurred more frequently in the lisdexamfetamine group than the placebo group.
The study has limitations. The biggest was its high participant attrition rate of 39%, which, although it is on par with other outpatient studies for methamphetamine use disorder, impacted the findings’ statistical strength.
The 2023 study was published in the journal Addiction.
Source: NCCRED via Medianet
Leave a Reply