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Meta-Analysis
. 2025 May-Jun;19(3):322-330.
doi: 10.1097/ADM.0000000000001422. Epub 2024 Nov 26.

Is Naltrexone Effective and Safe for Treating Amphetamine-Type Stimulant Use Disorder? A Systematic Review and Meta-analysis

Gabriel Bastien  1 , Christina McAnulty, Heidar Sharafi, Amani Mahroug, Laurent Elkrief, Daniela Ziegler, Simon Dubreucq, Louis-Christophe Juteau, Didier Jutras-Aswad
Affiliations
Meta-Analysis

Is Naltrexone Effective and Safe for Treating Amphetamine-Type Stimulant Use Disorder? A Systematic Review and Meta-analysis

Gabriel Bastien et al. J Addict Med. 2025 May-Jun.

Abstract

Objectives: We conducted a systematic review and meta-analysis (PROSPERO ID: CRD42023401796) of randomized placebo-controlled trials evaluating the effectiveness and safety of naltrexone as a standalone pharmacotherapy for amphetamine-type stimulant use disorder (ATSUD).

Methods: We searched EMBASE, MEDLINE, EBM Reviews, PsycINFO, CINAHL, Google Scholar, and trial registries on April 11, 2023, and updated on September 24, 2024, to identify randomized placebo-controlled trials evaluating the effectiveness of naltrexone for the treatment of ATSUD. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) guidelines were followed for reporting the study. Risk of bias and quality of evidence were assessed with the Cochrane Risk-of-bias Assessment tool and the Grading of Recommendations, Assessment, Development, and Evaluation. Risk ratios (RRs) or Peto odds ratio were estimated for binary outcomes as appropriate. Standardized mean differences were calculated for continuous outcomes.

Results: Five studies (n = 419 participants) were eligible. We found no significant difference between naltrexone and placebo for amphetamine-type stimulant use (RR = 0.903, 95% confidence interval [CI] = 0.698 to 1.167, P = 0.44, I2 = 96.1%; 4 studies), study retention (RR = 1.055, 95% CI = 0.942 to 1.182, P = 0.35, I2 = 45.0%; 4 studies), end-of-treatment craving (standardized mean difference = 0.069, 95% CI = -0.272 to 0.410, P = 0.69, I2 = 0.0%; 2 studies), and serious adverse events (odds ratio = 1.086, 95% CI = 0.414 to 2.849, P = 0.87, I2 = 0.0%; 3 studies). The quality of evidence was low to very low.

Conclusions: The available evidence does not support the use of standalone naltrexone to treat ATSUD. Significant research efforts must be put toward to identify effective pharmacotherapies to complement psychosocial interventions for ATSUD.

Keywords: amphetamine; meta-analysis; methamphetamine; naltrexone; stimulant use disorder.

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Conflict of interest statement

LE is a shareholder and employee of OneCare Inc, which is a biotechnology mental health company. OneCare Inc, biotechnologies’ work does not relate to the contents of the present article. DJA received investigational products from Cardiol Therapeutics and Exka for clinical trials funded by the Quebec Ministry of Health and Social Services (2022-2024). GB, CM, HS, AM, DZ, SB, and LCJ report no conflict of interests.

References

    1. GBD 2016 Alcohol and Drug Use Collaborators. The global burden of disease attributable to alcohol and drug use in 195 countries and territories, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Psychiatry. 2018;5(12):987–1012.
    1. World Drug Report 2023. (United Nations publications). (2023).
    1. Rahimi M, Lookzadeh S, Sadeghi R, et al. Predictive Factors of Mortality in Acute Amphetamine Type Stimulants Poisoning; a Review of 226 Cases. Emerg (Tehran). 2018;6(1):e1.
    1. The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder. J Addict Med. 2024;18(1S):1–56.
    1. Stoops WW, Rush CR. Combination pharmacotherapies for stimulant use disorder: a review of clinical findings and recommendations for future research. Expert Rev Clin Pharmacol. 2014;7(3):363–374.

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