selective serotonin reuptake inhibitors, tricyclic antidepressants ) have not been effective in reducing AMPH/MA use. Less consistent benefits have been shown with the antidepressants bupropion and mirtazapine, the glutamatergic agent riluzole and the corticotropin releasing factor (CRF-1) antagonist pexacerfont whilst in general, antidepressant medications (e.g. The most consistent positive findings have been demonstrated with stimulant agonist treatment (dexamphetamine and methylphenidate), naltrexone and topiramate. men who have sex with men), with some variation in efficacy signals dependent on baseline frequency of AMPH/MA use. Some studies demonstrated mixed or weak positive signals (often in defined populations, e.g. Disparate outcomes and measures ( n = 55 for the primary outcomes) across studies did not allow for meta-analyses. Our search returned 43 studies that met our criteria, collectively enrolling 4065 participants and reporting on 23 individual pharmacotherapies, alone or in combination. Outcome measures were any reported impact of treatment related to AMPH/MA use. The selected studies were evaluated for design methodology inclusion and exclusion criteria sample size pharmacological and (if included) psychosocial interventions length of follow-up and follow-up schedules outcome variables and measures results overall conclusions and risk of bias. We included all studies published to 19 June 2019. We systematically reviewed the peer-reviewed literature via the electronic databases PubMed, EMBASE, CINAHL and SCOPUS for randomised controlled trials reported in the English language examining a pharmacological treatment for AMPH/MA dependence or use disorder. A comprehensive assessment of the research literature on pharmacotherapy for AMPH/MA dependence may inform treatment guidelines and future research directions. Yet, there is no established pharmacotherapy for AMPH/MA dependence. Dependence on amphetamines (AMPH) or methamphetamine (MA) is a growing global concern. Stimulant drugs are second only to cannabis as the most widely used class of illicit drug globally, accounting for 68 million past-year consumers.

Treatment for amphetamine dependence