Abstract Issues Cessation of methamphetamine use may result in a characteristic withdrawal syndrome, no medication has been approved for this indication. This systematic review aims to assess the efficacy of pharmacotherapy for methamphetamine withdrawal, the first comprehensive meta‐analysis since 2008. Approach MEDLINE (1966–2020), CINAHL (1982–2020), PsychINFO (1806–2020) and EMBASE (1947–2020) were systematically searched. Studies were included if they were randomised controlled trials (RCT) investigating pharmacological treatments for methamphetamine withdrawal, reviewing outcomes of treatment discontinuation, mental health outcomes, withdrawal symptoms (including craving) and patient safety. The relative risk (RR) and weighted mean difference (MD) were used to meta‐analyse dichotomous and continuous data respectively, with 95% confidence intervals. Risk of bias and Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) assessments were conducted. Key Findings Nine RCTs of six medications ( n = 242 participants) met inclusion criteria, however, only six trials of four medications ( n = 186) could be meta‐analysed. Mean sample size across studies was 27 participants, and 88% of participants were male. The quality of evidence in this review varies from low to very low on GRADE assessments. Amineptine may reduce discontinuation rates (RR 0.22, 95% confidence interval [CI] 0.07, 0.72, p = 0.01), and improve global state (MD −0.49, 95% CI −0.80, −0.17), compared with placebo, however, this medication is no longer approved. No other medications improved any domain when compared with placebo. Due to lack of reporting safety profiles could not be established. Conclusions There is insufficient evidence to indicate any medication is effective for the treatment of methamphetamine withdrawal. The poor quality of the evidence indicates a need for better powered, high‐quality trials.
SHOW FULL ABSTRACT CITATION BIBTEX RIS
Liam S. Acheson, Benjamin H. Williams, Michael Farrell et al.. Pharmacological treatment for methamphetamine withdrawal: A systematic review and meta‐analysis of randomised controlled trials. Drug and Alcohol Review. (2022). https://doi.org/10.1111/dar.13511 Liam S. Acheson, Benjamin H. Williams, Michael Farrell, Rebecca McKetin, Nadine Ezard, Krista J. Siefried
1
The National Drug and Alcohol Research Centre
UNSW Sydney
Sydney
Australia 2
Alcohol and Drug Service
St Vincent's Hospital Sydney
Sydney
Australia 3
The National Centre for Clinical Research on Emerging Drugs
c/o UNSW Sydney
Sydney
Australia 4
Department of Psychiatry
Royal Prince Alfred Hospital, Sydney Local Health District
Sydney
Australia 5
New South Wales Drug and Alcohol Clinical Research and Improvement Network
Sydney
Australia 