Abstract
AimMethamphetamine (MA) abuse and dependence are increasing worldwide and are commonly associated with cognitive deficits. Some studies indicate that such impairments can improve if users become abstinent, but overall results remain inconclusive. Hence, we have performed a longitudinal case-control study investigating key surrogates for attention and impulsive decision-making before and after treatment.MethodsThirty patients with MA dependence and 24 non–substance-abusing control participants were recruited. Groups were matched on age, sex and education. All subjects performed a baseline assessment to obtain neurocognitive measures of sustained attention and delay discounting. Patients subsequently participated in an MA-specific relapse prevention program including repeated monitoring of relapse status. After 3 months, participants of both groups were reevaluated for neurocognitive performance.ResultsAt baseline, MA patients showed a significantly higher number of omissions compared to controls, indicative of lower sustained attention. Interestingly, we observed a steep decrease of omissions in MA patients to control-group level post treatment. On the other hand, MA patients discounted delayed rewards significantly stronger than controls, indicating a more impulsive choice behavior both before and after treatment.LimitationThe results should be interpreted with care because of the small sample and short follow-up period.ConclusionOur data support earlier findings on partial recovery of cognitive deficits in MA patients. They also strengthen the indication for recently recommended psychotherapeutic interventions and may provide a behavioral monitoring tool to inform treatment progress.
Highlights
Methamphetamine (MA) called “crystal meth” is a psychostimulant, whose use has become increasingly popular in several European countries [1]
The main aim of the present study was to determine whether cognitive impairments in attention and impulsive choice behavior in recently detoxified MA patients recover during a 3-month program, which included psychotherapy and regular drug screening
Our results showed that baseline performances in sustained attention, which were inferior compared with those of controls, improved so much during this period that they were no longer impaired at the follow-up session
Summary
Methamphetamine (MA) called “crystal meth” is a psychostimulant, whose use has become increasingly popular in several European countries [1]. Pharmacotherapy has shown limited effectiveness, making psychotherapeutic interventions the treatment of choice [7] These include cognitive behavioral therapy, motivational interviewing and contingency management, which aim to reduce drug use, positive urine samples and craving. Such recommendations vastly rely on the transfer of knowledge from overseas and may not be representative of the specific characteristics that are experienced locally. This is especially relevant when mechanistic aspects are not yet fully clarified, which include above all cognitive dysfunctions in MA users and their course under therapy. As such more research is urgently needed to strengthen the evidence for the recommended psychotherapeutic interventions and optimization of care [8]
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