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Randomized Controlled Trial
. 2014 Sep;109(9):1489-500.
doi: 10.1111/add.12608. Epub 2014 Jul 8.

Sustained-release methylphenidate in a randomized trial of treatment of methamphetamine use disorder

Walter Ling  1 , Linda Chang, Maureen Hillhouse, Alfonso Ang, Joan Striebel, Jessica Jenkins, Jasmin Hernandez, Mary Olaer, Larissa Mooney, Susan Reed, Erin Fukaya, Shannon Kogachi, Daniel Alicata, Nataliya Holmes, Asher Esagoff
Affiliations
Randomized Controlled Trial

Sustained-release methylphenidate in a randomized trial of treatment of methamphetamine use disorder

Walter Ling et al. Addiction. 2014 Sep.

Abstract

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 Los Angeles, California (LA) and Honolulu, Hawaii (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.

Keywords: Methamphetamine; RCT; methamphetamine use disorders; methylphenidate; randomized clinical trial; treatment.

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Figures

Figure 1
Figure 1
Study Participant Flow (Consort Diagram)
Figure 2
Figure 2
Self-Reported Methamphetamine Use for the Last 30 Days at Study Time-points by Treatment Group
Figure 3
Figure 3
Self-Reported Methamphetamine Use for the last 30 Days at Study Time-points by High vs Low Baseline Methamphetamine Use
Figure 4
Figure 4
Percent of UDS positive for MA at each study week by treatment group Week 1 daily dose = 18mg, Week 2 daily dose = 36mg; Weeks 3–10 daily dose = 54mg; Single-blind Placebo provided to all participants during Weeks 11–14
See this image and copyright information in PMC

Comment in

References

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