Abstract
BackgroundThe 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.MethodSixty-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.FindingsThere 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.ConclusionsThe 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.Trial registrationIranian Registry of Clinical Trials (IRCT) registration number: IRCT2015010320540N1. Date registered: April 10, 2015.
Highlights
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
Administration of 8 mg of buprenorphine per day can be recommended for the treatment of methamphetamine withdrawal cravings
As the buprenorphine is superior to bupropion, only buprenorphine does so for sure
Summary
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. Mental disorders have been growing problems around the world [1, 2]. Substance use disorders and substance-related disorders, involving mainly stimulants such as methamphetamines and cocaine, have been regarded as a developing problem worldwide. Methamphetamine abuse induces an elevated mood associated with increased wakefulness, physical activity, and energy [7]. Elongated use repeatedly ends to increase drug abuse, decreased weight, increased aggression, increased violence, poor impulse control, long-term health consequences, unstable mood, unstable affect, severe dependency, memory deficits, poor concentration, delusions, and hallucinations [12, 13]. Methamphetamine addiction is a chronic relapsing disorder requiring effective pharmacotherapies to help the prevention of relapse
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