Efficacy of bupropion and cognitive behavioral therapy in the treatment of methamphetamine use disorder: a systematic review and meta-analysis.

Abstract

To assess the efficacy of bupropion and cognitive behavioral therapy (CBT) compared with CBT alone in methamphetamine use disorder management. A systematic review study with meta-analysis was carried out. The selection criteria were randomized clinical trials that investigated the efficacy of bupropion and CBT in methamphetamine use disorder treatment under the detection of metabolites in urine. The search was conducted in Pubmed, PMC, LILACS, Scielo, Cochrane Library, SCOPUS, Google Scholar, Ovid Medline, Clinicaltrials.gov and ICTRP. The primary outcome was relapses. The risk of bias was assessed with ROB 2 tool. The researchers extracted the results of each clinical trial and placed them in an Excel spreadsheet. We performed a meta-analysis using RR with a 95% confidence interval. 597 initial articles were obtained, 498 after the removal of duplicate articles and only 5 studies were included in the meta-analysis. Together they gathered a sample of 539 patients. An overall RR of 0.91 (95% CI 0.78-1.05) was estimated for methamphetamine relapses. Regarding the limitations of our study, we found publication bias. We also included articles with heterogeneous populations. No evidence was found that bupropion and CBT reduced the risk of relapse compared to those receiving CBT and placebo.