A randomized clinical trial on the effects of bupropion and buprenorphine on the reduction of methamphetamine craving

• Published in: Current controlled trials in cardiovascular medicine Vol. 20; no. 1; p. 468
• Main Authors: Ahmadi, Jamshid, Sahraian, Ali, Biuseh, Mehdi
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 30.07.2019; BioMed Central; BMC
• Subjects: Adolescent; Adult; Alcohol; Amphetamine-Related Disorders - diagnosis; Amphetamine-Related Disorders - drug therapy; Amphetamine-Related Disorders - psychology; Analgesics, Opioid - adverse effects; Analgesics, Opioid - therapeutic use; Behavior, Addictive - diagnosis; Behavior, Addictive - drug therapy; Behavior, Addictive - psychology; Buprenorphine; Buprenorphine - adverse effects; Buprenorphine - therapeutic use; Bupropion; Bupropion - adverse effects; Bupropion - therapeutic use; Central Nervous System Stimulants - adverse effects; Clinical trials; Cocaine; Complications and side effects; Craving - drug effects; Dopamine; Dopamine Uptake Inhibitors - adverse effects; Dopamine Uptake Inhibitors - therapeutic use; Dosage and administration; Double-Blind Method; Drug abuse; Drug dosages; Drug testing; Drug therapy; Drug use; Drug withdrawal; Hallucinations; Handbooks; Humans; Interviews; Iran; Male; Marriage; Medical research; Mental disorders; Methadone; Methamphetamine; Methamphetamine - adverse effects; Methamphetamine withdrawal craving; Middle Aged; Narcotics; Psychiatric hospitals; Psychiatrists; Psychosis; Substance abuse treatment; Substance use disorder; Substance Withdrawal Syndrome - diagnosis; Substance Withdrawal Syndrome - drug therapy; Substance Withdrawal Syndrome - psychology; Time Factors; Treatment Outcome; Urine; Variance analysis; Young Adult; Iran; Buprenorphine; Bupropion; Methamphetamine withdrawal craving
• ISSN: 1745-6215; 1745-6215
• DOI: 10.1186/s13063-019-3554-6

The purpose of this study was to compare the effect of 300 mg of bupropion and 8 mg of buprenorphine per day on the treatment of methamphetamine withdrawal cravings over a 2-week treatment interval. Sixty-five methamphetamine-dependent men who met the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision) criteria for methamphetamine dependence and withdrawal were randomly divided into two groups. Subjects randomly received 300 mg of bupropion or 8 mg of buprenorphine per day in a psychiatric ward. Of the 65 subjects, 35 (53.8%) received buprenorphine and 30 (46.2%) received bupropion. The subjects were assessed by using methamphetamine craving score, interview, and negative urine drug test. There were no statistically significant differences between the two groups in regard to age, education, duration of methamphetamine dependency, marital status, employment, and income. The mean ages were 32.8 years (standard deviation (SD) = 7.26, range = 22 to 59) for the buprenorphine group and 32.21 years (SD = 8.45, range = 17 to 51) for the bupropion group. All 65 patients completed the 2-week study. Both medications were effective in the reduction of methamphetamine cravings. Reduction of craving in the buprenorphine group was significantly more than the bupropion group (P = 0.011). Overall, a significant main effect of day (P <0.001) and group (P = 0.011) and a non-significant group-by-day interaction (P >0.05) were detected. The results support the safety and effectiveness of buprenorphine and bupropion in the treatment of methamphetamine withdrawal craving. Administration of 8 mg of buprenorphine per day can be recommended for the treatment of methamphetamine withdrawal cravings. We should note that it is to be expected that craving decreases over time without any medication. So the conclusion may not be that bupropion and buprenorphine both lower the craving. As the buprenorphine is superior to bupropion, only buprenorphine does so for sure. Iranian Registry of Clinical Trials (IRCT) registration number: IRCT2015010320540N1 . Date registered: April 10, 2015.