Aripiprazole for the treatment of methamphetamine dependence: a randomized, double‐blind, placebo‐controlled trial. (3rd January 2013)

• Record Type: Journal Article
• Authors: Coffin, Phillip Oliver; Santos, Glenn‐Milo; Das, Moupali; Santos, Deirdre M.; Huffaker, Shannon; Matheson, Tim; Gasper, James; Vittinghoff, Eric; Colfax, Grant N.
• Is Part Of: Addiction. Volume 108:Number 4(2013:Apr.)
• Page Start: 751
• Page End: 761
• Publication Date: 2013-01-03
• Subjects: Alcoholism -- Periodicals; Drug addiction -- Periodicals; 616.86
• DOI: 10.1111/add.12073
• Languages: English
• ISSNs: 0965-2140

Abstract

<abstract abstract-type="main"> <title>Abstract</title> <sec id="add12073-sec-0001" sec-type="section"> <title>Aims</title> <p>To test aripiprazole for efficacy in decreasing use in methamphetamine‐dependent adults, compared to placebo.</p> </sec> <sec id="add12073-sec-0002" sec-type="section"> <title>Design</title> <p>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.</p> </sec> <sec id="add12073-sec-0003" sec-type="section"> <title>Setting</title> <p>The trial was conducted from January 2009 to March 2012 at the San Francisco Department of Public Health.</p> </sec> <sec id="add12073-sec-0004" sec-type="section"> <title>Participants</title> <p>Ninety actively using, methamphetamine‐dependent, sexually active adults were recruited from community venues.</p> </sec> <sec id="add12073-sec-0005" sec-type="section"> <title>Measurements</title> <p>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.</p> </sec> <sec id="add12073-sec-0006" sec-type="section"> <title>Findings</title> <p>Participant mean age was 38.7 years, 87.8% were male, 50.0% white, 18.9% African American, and 16.7% Latino. Eighty‐three per cent 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 [risk ratio (RR) 0.88, 95% confidence interval (CI): 0.66–1.19, <italic>P</italic> = 0.41]. Urine positivity declined from 73% (33 of 45 participants) to 45% (18 of 40) in the placebo arm and from 77% (34 of 44) to 44% (20 of 35) in the aripiprazole arm. Adherence by MEMS and self‐report was 42 and 74%, respectively, with no significant difference between arms (MEMS <italic>P</italic> = 0.31; self‐report <italic>P</italic> = 0.17). Most sexual risk behaviors declined similarly among participants in both arms (all <italic>P</italic> > 0.05). There were no serious adverse events related to study drug, although participants randomized to aripiprazole reported more akathisia, fatigue and drowsiness (<italic>P</italic> < 0.05).</p> </sec> <sec id="add12073-sec-0007" sec-type="section"> <title>Conclusion</title> <p>Compared with placebo, aripiprazole did not reduce methamphetamine use significantly among actively using, dependent adults.</p> </sec> </abstract>