Addiction Rehab: Aripiprazole for the Treatment of Methamphetamine Dependence: A Randomized, Double-Blind, Placebo-Controlled Trial.

Aripiprazole for the treatment of methamphetamine dependence: A randomized, double-blind, placebo-controlled trial.

Filed under: Addiction Rehab

Addiction. 2012 Nov 27;
Coffin P, Santos G, Das M, Santos D, Huffaker S, Matheson T, Gasper J, Vittinghoff E, Colfax G

AIMS: To test aripiprazole for efficacy in decreasing use in methamphetamine-dependent adults, compared to placebo. DESIGN: Participants were randomized to receive 12 weeks of aripiprazole or placebo, with a 3 month follow-up and a platform of weekly 30-minute substance abuse counseling. SETTING: The trial was conducted from January 2009 to March 2012 at the San Francisco Department of Public Health. PARTICIPANTS: Ninety actively-using, methamphetamine-dependent, sexually active, adults were recruited from community venues. MEASUREMENTS: The primary outcome was regression estimated reductions in weekly methamphetamine-positive urines. Secondary outcomes were study medication adherence (by self-report and medication event monitoring systems [MEMS]), sexual risk behavior, and abstinence from methamphetamine. FINDINGS: Participant mean age was 38.7 years, 87.8% were male, 50.0% white, 18.9% African-American, and 16.7% Latino. Eighty-three percent of follow-up visits and final visits were completed. By intent-to-treat, participants assigned to aripiprazole had similar reductions in methamphetamine-positive urines as participants assigned to placebo (RR 0.88, 95% CI 0.66-1.19, P=0.41). Urine positivity declined from 73% (33/45 participants) to 45% (18/40) in the placebo arm, and from 77% (34/44) to 44% (20/35) in the aripiprazole arm. Adherence by MEMS and self-report was 42% and 74%, respectively, with no significant difference between arms (MEMS P=0.31; self-report P=0.17). Most sexual risk behaviors declined similarly among participants in both arms (all P>0.05). There were no serious adverse events related to study drug, although participants randomized to aripiprazole reported more akathisia, fatigue, and drowsiness (P<0.05). CONCLUSION: Compared with placebo, aripiprazole did not significantly reduce methamphetamine use among actively-using, dependent adults. HubMed – addiction



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