View this page "Three abstracts on Meth treatment pharmacotherapy "

[Rick Bevins]

Hello everyone,

See below for three abstracts on methamphetamine pharmacotherapy
treatment provided by Dr. Grant.

Thank you,
Kathleen
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Drug Alcohol Rev. 2010 May;29(3):235-42.

A cost-effectiveness analysis of modafinil therapy for psychostimulant
dependence.

Shearer J, Shanahan M, Darke S, Rodgers C, VAN Beek I, McKetin R,
Mattick RP.

Peninsula Medical School, University of Exeter, Exeter, United
Kingdom.

Abstract
Introduction and Aims. To examine the cost-effectiveness of modafinil
(200 mg daily) plus counselling compared with placebo for the
treatment of psychostimulant dependence. Design and Methods. Cost and
outcome data were collected alongside two randomised controlled trials
of modafinil 200 mg daily over 10 weeks for methamphetamine (n = 74)
and cocaine dependence (n = 8), respectively. Incremental cost-
effectiveness ratios representing the additional costs to achieve a
given outcome were calculated for both the change in the number of
stimulant-free days and quality-adjusted life years 12 weeks post-
treatment. Results. The incremental cost-effectiveness ratio indicated
that it would cost an additional $AUD79 to achieve an extra stimulant-
free day with modafinil compared with placebo. This result was not
statistically significant, but appeared to be a robust estimate after
sensitivity analysis. Counselling, whether received within program or
from other services, improved the cost-effectiveness of modafinil
relative to placebo. Discussion and Conclusions. Strategies to improve
the uptake of counselling are recommended as cost-effective.[Shearer
J, Shanahan M, Darke S, Rodgers C, van Beek I, McKetin R, Mattick RP.
A cost-effectiveness analysis of modafinil therapy for psychostimulant
dependence. Drug Alcohol Rev 2010].

_________________________________

Prog Neuropsychopharmacol Biol Psychiatry. 2010 Jun 15. [Epub ahead of
print]

Aripiprazole attenuates established behavioral sensitization induced
by methamphetamine.

Futamura T, Akiyama S, Sugino H, Forbes A, McQuade RD, Kikuchi T.

Q's Research Institute, Otsuka Pharmaceutical Co., Ltd., Tokushima,
771-0192, Japan.

Abstract
Psychostimulant-induced behavioral sensitization is an experimental
model of the stimulant psychosis and the vulnerability to relapse in
schizophrenia. This study investigated the effects of aripiprazole, an
antipsychotic drug that has dopamine D2 receptor partial agonist
activity, on established sensitization induced by methamphetamine
(MAP) in mice. Repeated treatment with MAP (1.0mg/kg, s.c.) for 10days
progressively increased the ability of MAP to increase locomotor
activity. The enhanced locomotion induced by a challenge dose of MAP
(0.24mg/kg, s.c.) also occurred after withdrawal from MAP
pretreatment. Repeated treatment with aripiprazole from days 10 to 14
during withdrawal from MAP administration attenuated the effect of MAP
pretreatment, enhancing the motor response to a challenge dose of
stimulant 3days after the aripiprazole preparation. In contrast,
sulpiride, a dopamine D2 receptor specific antagonist, and
risperidone, a serotonin 5-HT2 and dopamine D2 receptor antagonist,
did not show effects similar to aripiprazole. The attenuation effect
of aripiprazole was blocked by pretreatment with the specific
serotonin 5-HT1A antagonist WAY100635. These results of aripiprazole
suggest that the attenuation effect of aripiprazole was mediated by 5-
HT1A receptors and imply that aripiprazole may have therapeutic value
in treating drug-induced psychosis and schizophrenia. Copyright ©
2010. Published by Elsevier Inc.

PMID: 20561555 [PubMed - as supplied by publisher]

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Br J Clin Pharmacol. 2010 Jun;69(6):578-92.

Pharmacological approaches to methamphetamine dependence: a focused
review.
Karila L, Weinstein A, Aubin HJ, Benyamina A, Reynaud M, Batki SL.

Addiction Research and Treatment Center, Paul Brousse Hospital, Paris
XI University, AP-HP, CEA- INSERM U1000, Villejuif, France.

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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