Safety of intravenous methamphetamine administration during treatment with bupropion

Newton, Thomas F.; Roache, John D.; Garza, Richard De La; Fong, Tim; Wallace, Christopher L.; Li, Shou Hua; Elkashef, Ahmed; Chiang, Nora; Kahn, Roberta

doi:10.1007/s00213-005-0102-8

Cited by 59 publications

(46 citation statements)

References 24 publications

(20 reference statements)

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“…Even less is known about these effects with the intravenous formulation of methamphetamine administered in the human laboratory. The present study establishes the hemodynamic and cardiovascular effects and safety of experimenter-administered intravenous methamphetamine, thereby building upon other human laboratory data (Newton et al, 2005a(Newton et al, , 2005b. Notably, the administration of intravenous methamphetamine doses of up to 30 mg under controlled human laboratory conditions to methamphetamine addicts appears to be safe and only associated with prototypical increases in hemodynamic response.…”

Section: Discussionsupporting

confidence: 57%

Kinetic and cardiovascular effects of acute topiramate dosing among non-treatment-seeking, methamphetamine-dependent individuals

Johnson

Wells

Roache

et al. 2007

Progress in Neuro-Psychopharmacology and Biological Psychiatry

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Previously, we have shown that orally administered topiramate, a sulfamate-substituted fructopyranose derivative, appears to accentuate rather than diminish some aspects of methamphetamine-induced positive subjective mood and cognitive performance. One possible mechanism by which this might occur would be for topiramate to increase plasma methamphetamine level. Such an effect also would be expected to enhance methamphetamine-induced hemodynamic response. We, therefore, studied -in the same experiment from which the previous findings originated -the effects of topiramate on the kinetic profile and hemodynamic response to methamphetamine. In a 27-day inpatient study, 10 methamphetamine-dependent individuals participated in a double-blind, placebo-controlled, cross-over design, with oral doses of topiramate (0, 100, and 200 mg) administered as a pretreatment before intravenous doses of methamphetamine (0, 15, and 30 mg). The 3 × 3 factorial combination of topiramate and methamphetamine resulted in a sequence of the nine treatments administered to each subject in an order determined by a 9 × 9 Latin Square design. Methamphetamine alone was associated with prototypical increases in hemodynamic response that were not altered in the presence of topiramate. While there was no significant kinetic interaction between topiramate and methamphetamine, there was a non-significant trend for topiramate to increase plasma methamphetamine level. No significant adverse events were reported. The combination of topiramate and methamphetamine at pharmacologically relevant doses appears to be safe. Larger laboratory studies with chronic dosing regimens are needed to establish whether or not there is a kinetic interaction between topiramate and methamphetamine.

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Section: Discussionsupporting

confidence: 57%

Kinetic and cardiovascular effects of acute topiramate dosing among non-treatment-seeking, methamphetamine-dependent individuals

Johnson

Wells

Roache

et al. 2007

Progress in Neuro-Psychopharmacology and Biological Psychiatry

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“…Adverse events observed in this study were minor, with both active and placebo groups reporting similar magnitude and severity of events. In fact, bupropion treatment tended to blunt the cardiovascular effects of experimentally administered methamphetamine, with this effect reaching statistical significance for heart rate (Newton et al, 2005).…”

Section: Discussionmentioning

confidence: 95%

Bupropion Reduces Methamphetamine-Induced Subjective Effects and Cue-Induced Craving

Newton

Roache

Garza

et al. 2005

Neuropsychopharmacol

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139

126

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Bupropion is an antidepressant with stimulant properties, which inhibits the reuptake of dopamine (DA) and norepinepherine, and is purported to enhance DA neurotransmission. Bupropion is considered an appealing candidate medication for the treatment of methamphetamine dependence. The current laboratory study was set forth to assess the impact of bupropion treatment on the subjective effects produced by methamphetamine in the laboratory. We also assessed the effects of bupropion treatment on craving elicited by exposure to videotaped methamphetamine cues. A total of 26 participants were enrolled and 20 completed the entire study (n ¼ 10 placebo and n ¼ 10 bupropion, parallel groups design). Bupropion treatment was associated with reduced ratings of 'any drug effect' (po0.02), and 'high' (po0.02) following methamphetamine administration. There was also a significant bupropion-by-cue exposure interaction on General Craving Scale total score (po0.002), and on the Behavioral Intention subscale (po0.001). Overall, the data reveal that bupropion reduced acute methamphetamine-induced subjective effects and reduced cue-induced craving. Importantly, these data provide a rationale for the evaluation of bupropion in the treatment of methamphetamine dependence.

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“…Before conducting this outpatient trial, we conducted a phase I safety study of the interactions between bupropion and methamphetamine (Newton et al, 2005). That study showed bupropion did not exacerbate the cardiovascular or behavioral effects induced by methamphetamine.…”

Section: Introductionmentioning

confidence: 99%

Bupropion for the Treatment of Methamphetamine Dependence

Elkashef

Rawson

Anderson

et al. 2007

Neuropsychopharmacol

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193

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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Safety of intravenous methamphetamine administration during treatment with bupropion

Cited by 59 publications

References 24 publications

Kinetic and cardiovascular effects of acute topiramate dosing among non-treatment-seeking, methamphetamine-dependent individuals

Kinetic and cardiovascular effects of acute topiramate dosing among non-treatment-seeking, methamphetamine-dependent individuals

Bupropion Reduces Methamphetamine-Induced Subjective Effects and Cue-Induced Craving

Bupropion for the Treatment of Methamphetamine Dependence

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