A multicenter trial of bupropion for cocaine dependence in methadone-maintained patients

Margolin, Arthur; Kosten, Thomas R.; Avants, S. Kelly; Wilkins, Jeffery N.; Ling, Walter; Beckson, Mace; Arndt, I; Cornish, James; Ascher, John; Li, Shou-Hua; Bridge, Peter

doi:10.1016/0376-8716(95)01198-6

Cited by 157 publications

(107 citation statements)

References 35 publications

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“…However, the biochemical testing methods used in this study do not preclude the use of nonnicotine pharmacotherapies for smoking cessation, such as bupropion. Bupropion has been shown to aid smoking cessation efforts to a similar degree as nicotinebased pharmacotherapies (Hughes, Stead, & Lancaster, 2004) and has been well tolerated in several prior studies with MM patients (Margolin et al, 1995;Margolin, Kosten, Petrakis, Avants, & Kosten, 1990).…”

Section: Discussionmentioning

confidence: 99%

Voucher‐based Contingent Reinforcement of Smoking Abstinence Among Methadone‐maintained Patients: A Pilot Study

Dunn

Sigmon

Thomas

et al. 2008

J of App Behav Analysis

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This study evaluated the efficacy of a contingency management (CM) intervention to promote smoking cessation in methadone-maintained patients. Twenty participants, randomized into contingent (n 5 10) or noncontingent (n 5 10) experimental conditions, completed the 14-day study. Abstinence was determined using breath carbon monoxide and urine cotinine levels. Contingent participants received voucher-based incentives for biochemical evidence of smoking abstinence. Noncontingent participants earned vouchers independent of smoking status. Contingent participants achieved significantly more smoking abstinence and longer durations of continuous smoking abstinence than did noncontingent participants. These results support the potential efficacy of using voucher-based CM to promote smoking cessation among methadonemaintained patients.

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Section: Discussionmentioning

confidence: 99%

Voucher‐based Contingent Reinforcement of Smoking Abstinence Among Methadone‐maintained Patients: A Pilot Study

Dunn

Sigmon

Thomas

et al. 2008

J of App Behav Analysis

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“…These effects may help alleviate some of the symptoms of withdrawal from methamphetamine, which mimic some vegetative symptoms of depression (Newton et al, 2004), and could help reduce methamphetamine dependence in participants who have comorbid depression or ADHD. In a clinical trial of bupropion for cocaine dependence (Margolin et al, 1995), an exploratory analysis suggested participants with greater levels of depression might have benefited the most.…”

Section: Introductionmentioning

confidence: 99%

Bupropion for the Treatment of Methamphetamine Dependence

Elkashef

Rawson

Anderson

et al. 2007

Neuropsychopharmacol

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188

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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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“…A randomized, placebo-controlled trial of bupropion for cocaine dependence found a significant effect for bupropion relative to placebo in reducing cocaine use when provided with a contingency management intervention, but not with a non-contingent voucher program (Poling et al, 2006). Two other randomized placebo-controlled trials of bupropion plus cognitive behavioral therapy failed to find an effect for bupropion in cocaine dependence (Margolin et al, 1995;Shoptaw et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Randomized, placebo-controlled trial of bupropion for the treatment of methamphetamine dependence

Shoptaw

Heinzerling

Rotheram-Fuller

et al. 2008

Drug and Alcohol Dependence

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132

129

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Objective-To compare bupropion to placebo for reducing methamphetamine (MA) use, increasing retention, and reducing the severity of depressive symptoms and MA cravings. A secondary objective compared bupropion to placebo for reducing cigarette smoking among MA dependent participants.Methods-Following a 2-week, non-medication baseline screening period, 73 treatment-seeking MA dependent participants were randomly assigned to bupropion sustained release (150 mg twice daily; N=36) or placebo (twice daily; N=37) for 12-weeks under double blind conditions. Participants attended clinic thrice weekly to provide urine samples analyzed for MA-metabolite, to complete research measures and assessments, and to receive contingency management and weekly cognitive behavioral therapy sessions.Results-There were no statistically significant effects for bupropion relative to placebo on MA use verified by urine drug screens, for reducing the severity of depressive symptoms or MA cravings, or on study retention. In a post hoc analysis, there was a statistically significant effect of bupropion treatment on MA use among participants with lighter (0-2 MA-positive urines), but not heavier (3-6 MA-positive urines) MA use during baseline (OR=2.81, 95% CI=1.61-4.93, p<0.001 for MA-free week with bupropion among light users). Bupropion treatment was also associated with significantly reduced cigarette smoking, by almost 5 cigarettes per day (p=0.0002).Conclusion-Bupropion was no more effective than placebo in reducing MA use in planned analyses, though bupropion did reduce cigarette smoking. Post hoc findings of an effect for bupropion among baseline light, but not heavy, MA users suggests further evaluation of bupropion for light MA users is warranted.

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A multicenter trial of bupropion for cocaine dependence in methadone-maintained patients

Cited by 157 publications

References 35 publications

Voucher‐based Contingent Reinforcement of Smoking Abstinence Among Methadone‐maintained Patients: A Pilot Study

Voucher‐based Contingent Reinforcement of Smoking Abstinence Among Methadone‐maintained Patients: A Pilot Study

Bupropion for the Treatment of Methamphetamine Dependence

Randomized, placebo-controlled trial of bupropion for the treatment of methamphetamine dependence

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