| A retrospective analysis of two randomized trials of bupropion for methamphetamine dependence: suggested guidelines for treatment discontinuation/augmentation. | |
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MedLine Citation:
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PMID: 22534658 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Two clinical trials have shown efficacy for bupropion in treating methamphetamine (MA) dependence among those with moderate baseline MA use. However, treatment response is highly variable and it is unclear what duration of treatment is necessary to determine if maintaining the treatment course is indicated or if discontinuation or augmentation is appropriate. The present study assessed the relationship among early bupropion treatment response for moderate MA users and end-of-treatment (EOT) abstinence. These data provide estimates of the duration of treatment and the degree of responsiveness required to persist in bupropion treatment. METHODS: Participants with moderate baseline MA use in the bupropion condition of two randomized double-blind placebo controlled trials were included. The relationship between early treatment response and EOT outcomes was assessed with Receiver Operating Characteristic (ROC) curves. RESULTS: With thrice weekly urine drug testing, excellent predictive power was established in the first two weeks of treatment. The inability to achieve at least three MA negative samples in the first two weeks is associated with greater than 90% likelihood of treatment failure. More closely approximating clinical settings, once-weekly testing featured reliable predictive power within three weeks, suggesting that the failure to produce at least two clean samples in the first three weekly visits confers high risk of treatment failure. DISCUSSION: The findings provide preliminary evidence to guide clinical decisions for moderate MA users receiving bupropion. The results are consistent with data from the smoking cessation literature and may highlight the importance of early response in addiction treatment. |
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Authors:
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Matthew Brensilver; Keith G Heinzerling; Aimee-Noelle Swanson; Steven J Shoptaw |
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Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural Date: 2012-04-23 |
Journal Detail:
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Title: Drug and alcohol dependence Volume: 125 ISSN: 1879-0046 ISO Abbreviation: Drug Alcohol Depend Publication Date: 2012 Sep |
Date Detail:
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Created Date: 2012-08-14 Completed Date: 2012-12-27 Revised Date: 2013-04-16 |
Medline Journal Info:
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Nlm Unique ID: 7513587 Medline TA: Drug Alcohol Depend Country: Ireland |
Other Details:
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Languages: eng Pagination: 169-72 Citation Subset: IM |
Copyright Information:
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Copyright © 2012 Elsevier Ireland Ltd. All rights reserved. |
Affiliation:
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Department of Family Medicine, David Geffen School of Medicine at UCLA, CA 90095, USA. mbrensilver@mednet.ucla.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Amphetamine-Related Disorders / drug therapy* Bupropion / therapeutic use* Dopamine Uptake Inhibitors / therapeutic use* Double-Blind Method Female Guidelines as Topic Humans Male Methamphetamine* / urine ROC Curve Randomized Controlled Trials as Topic Retrospective Studies Substance Abuse Detection Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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N01-DA8804/DA/NIDA NIH HHS; N01-DA8824/DA/NIDA NIH HHS; P50 DA018185/DA/NIDA NIH HHS; P50 DA18185/DA/NIDA NIH HHS; T32 DA026400/DA/NIDA NIH HHS; T32 DA026400/DA/NIDA NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Dopamine Uptake Inhibitors; 34841-39-9/Bupropion; 537-46-2/Methamphetamine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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