A multi‐site comparison of psychosocial approaches for the treatment of methamphetamine dependence

Rawson, Richard A.; Marinelli‐Casey, Patricia; Anglin, M. Douglas; Dickow, Alice; Frazier, Yvonne; Gallagher, Cheryl; Galloway, Gantt P.; Herrell, James M.; Huber, Alice; McCann, Michael; Obert, Jeanne L.; Pennell, Susan; Reiber, Chris; Vandersloot, Denna; Zweben, Joan E.

doi:10.1111/j.1360-0443.2004.00707.x

Cited by 338 publications

(250 citation statements)

References 17 publications

(32 reference statements)

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“…The need to find effective medication treatment is urgent, as currently there is no Food and Drug Administration (FDA)-approved pharmacological treatment for stimulant dependence. Psychotherapeutic interventions remain the mainstay of treatment, with some proven efficacy; however, relapse rates remain high (Rawson et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

Bupropion for the Treatment of Methamphetamine Dependence

Elkashef

Rawson

Anderson

et al. 2007

Neuropsychopharmacol

192

186

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Bupropion was tested for efficacy in increasing weeks of abstinence in methamphetamine-dependent patients, compared to placebo. This was a double-blind placebo-controlled study, with 12 weeks of treatment and a 30-day follow-up. Five outpatient substance abuse treatment clinics located west of the Mississippi participated in the study. One hundred and fifty-one treatment-seekers with DSM-IV diagnosis of methamphetamine dependence were consented and enrolled. Seventy-two participants were randomized to placebo and 79 to sustained-release bupropion 150 mg twice daily. Patients were asked to come to the clinic three times per week for assessments, urine drug screens, and 90-min group psychotherapy. The primary outcome was the change in proportion of participants having a methamphetamine-free week. Secondary outcomes included: urine for quantitative methamphetamine, self-report of methamphetamine use, subgroup analyses of balancing factors and comorbid conditions, addiction severity, craving, risk behaviors for HIV, and use of other substances. The generalized estimating equation regression analysis showed that, overall, the difference between bupropion and placebo groups in the probability of a non-use week over the 12-week treatment period was not statistically significant (p ¼ 0.09). Mixed model regression was used to allow adjustment for baseline factors in addition to those measured (site, gender, level of baseline use, and level of symptoms of depression). This subgroup analysis showed that bupropion had a significant effect compared to placebo, among male patients who had a lower level of methamphetamine use at baseline (po0.0001). Comorbid depression and attention-deficit/ hyperactivity disorder did not change the outcome. These data suggest that bupropion, in combination with behavioral group therapy, was effective for increasing the number of weeks of abstinence in participants with low-to-moderate methamphetamine dependence, mainly male patients, regardless of their comorbid condition.

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Section: Introductionmentioning

confidence: 99%

Bupropion for the Treatment of Methamphetamine Dependence

Elkashef

Rawson

Anderson

et al. 2007

Neuropsychopharmacol

192

186

View full text Add to dashboard Cite

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“…Nevertheless, the effects of topiramate on methamphetamine-induced enhancement of cognitive performance and attention are not known. Obviously, if topiramate was shown to impair methamphetamine-induced cognitive enhancement, this could be an important obstacle in the pairing of skills or cognitive-based therapies -presently the mainstay of psychosocial treatment for methamphetamine dependence (Rawson et al, 2004) -with topiramate treatment. In such an eventuality, the practical recommendation might be for clinical trials to pair topiramate with behavioral or simple compliance-based psychosocial interventions.…”

Section: Introductionmentioning

confidence: 99%

Effects of topiramate on methamphetamine-induced changes in attentional and perceptual-motor skills of cognition in recently abstinent methamphetamine-dependent individuals

Johnson

Roache

Ait-Daoud

et al. 2007

Progress in Neuro-Psychopharmacology and Biological Psychiatry

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Methamphetamine-dependent individuals often cite the need to maintain enhanced cognitive performance and attention as a reason for continuing or relapsing to drug-taking. Further, methamphetamine addicts might not comply with taking a potentially therapeutic medication if it had a profound effect on these cognitive processes. Topiramate, a sulfamate-substituted fructopyranose derivative, has been suggested as a putative therapeutic medication for treating methamphetamine dependence. Examination of topiramate's effects on cognitive performance and attention is a clinically and scientifically important component of understanding its potential therapeutic profile. In 10 male and female individuals who met DSM-IV criteria for methamphetamine dependence, we examined the effects of low (50 mg b.i.d.)-and high (100 mg b.i.d.)-dose topiramate -in both the presence and absence of low (15 mg)-and high (30 mg)-dose intravenous methamphetamine -on cognitive performance, attention, and concentration on the rapid visual information processing task and the digit symbol substitution test. Intravenous methamphetamine enhanced cognitive performance, attention, and concentration among recently withdrawn methamphetamine addicts -an effect that hitherto had not been well characterized. Topiramate's cognitive effects were mixed and rather paradoxical, with a tendency to improve attention and concentration both alone and in the presence of methamphetamine while worsening psychomotor retardation. No deleterious interaction occurred between topiramate and methamphetamine on any of these cognitive processes. While clinical studies with topiramate should Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access

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“…In a multi-site study using the Matrix Model, Rawson et al [15] compared treatment as usual with the multi-component treatment, which includes group CBT, group family education, group social support and individual counselling over 16 weeks. Both groups improved significantly.…”

Section: Relapse Preventionmentioning

confidence: 99%

A systematic review of cognitive and behavioural therapies for methamphetamine dependence

Lee

Rawson

2008

Drug and Alcohol Review

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Introduction and Aims. The use of methamphetamine is widespread and poses significant challenges for treatment providers. Much of the treatment knowledge about this group has been extrapolated from studies of treatment for cocaine dependence. Medications have been shown to be of limited effectiveness for methamphetamine users, making psychological interventions the treatment of choice. Approach. This paper describes a systematic review of cognitive -behavioural and behavioural interventions for methamphetamine users. A systematic search of published literature was undertaken focusing only on randomised trials. Key Findings. There were a relatively small number of intervention studies that compared cognitivebehavioural or behavioural interventions using randomised trial methodology. Most commonly, studies examined cognitivebehaviour therapy (CBT) and/or contingency management (CM). Treatment with CBT appears to be associated with reductions in methamphetamine use and other positive changes, even over very short periods of treatment (two and four sessions). CM studies found a significant reduction of methamphetamine during application of the procedure, but it is not clear if these gains are sustained at post-treatment follow-up. Implications. The review highlights that there are effective treatments for methamphetamine dependence. Alcohol and other drug (AOD) clinicians are familiar with these types of interventions and should use them and convey to clients that they are effective. Services and policy makers should ensure that best practice interventions are implemented within AOD services. Conclusion. Psychological intervention is effective in addressing methamphetamine use and dependence. CBT and contingency management are two accessible interventions that are implemented easily within current AOD services. There is still more work to conduct in improving methamphetamine treatment, however, and further research into cognitive -behavioural and behavioural treatments for methamphetamine users is required, with a focus on improving longevity of the effect of intervention and improving effectiveness among more complex presentations.[Lee NK, Rawson RA. A systematic review of cognitive and behavioural therapies for methamphetamine dependence. Drug Alcohol Rev 2008;27:309-317]

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A multi‐site comparison of psychosocial approaches for the treatment of methamphetamine dependence

Cited by 338 publications

References 17 publications

Bupropion for the Treatment of Methamphetamine Dependence

Bupropion for the Treatment of Methamphetamine Dependence

Effects of topiramate on methamphetamine-induced changes in attentional and perceptual-motor skills of cognition in recently abstinent methamphetamine-dependent individuals

A systematic review of cognitive and behavioural therapies for methamphetamine dependence

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