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Article: Efficacy and safety of naltrexone for amfetamine and methamfetamine use disorder: A systematic review of randomized controlled trials.

TitleEfficacy and safety of naltrexone for amfetamine and methamfetamine use disorder: A systematic review of randomized controlled trials.
Authors
KeywordsAmfetamine
methamfetamine
naltrexone
safety
tolerability
Issue Date2018
PublisherTaylor & Francis Inc. The Journal's web site is located at http://www.tandfonline.com/ictx
Citation
Clinical Toxicology, 2018, v. 57 n. 4, p. 225-233 How to Cite?
AbstractIntroduction: Amfetamine and methamfetamine abuse remains a prevalent health problem, increasing the burden on healthcare. Naltrexone, a mu-opioid receptor antagonist, has been suggested as a promising treatment for amfetamine and methamfetamine use disorder. Objective: To review the current evidence for the efficacy and safety of naltrexone as a pharmacological treatment for amfetamine and methamfetamine use disorder. The primary outcome was defined as abstinence or reduction of use. Secondary outcomes were, attenuated 'positive' subjective effects (e.g., 'feel good,' 'craving,' etc.) of amfetamine or methamfetamine after naltrexone treatment, adverse events and physiological changes (e.g., blood pressure, heart rate). Methods: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A systematic literature search was conducted on 2 April 2017, and updated on 31 March 2018. Records were retrieved from databases including PubMed, EMBASE Classic plus EMBASE 1980 via Ovid, and the databases were searched using keywords and/or headings: (naltrexone AND amfetamine AND dependence) OR (naltrexone AND amfetamine AND craving) OR (vivitrol AND amfetamine) OR (revia AND amfetamine) OR (naltrexone AND amfetamine) OR (naltrexone AND methamfetamine dependence) OR (naltrexone AND methamfetamine AND craving) OR (vivitrol AND methamfetamine) OR (revia AND methamfetamine) OR (naltrexone AND ice) OR (naltrexone AND crystal meth) OR (naltrexone AND methamfetamine). Studies investigating the effects of naltrexone on amfetamine or methamfetamine use were eligible for inclusion. All studies were rated as low risk of bias using the Cochrane tool for risk of bias. Results: Among 591 identified studies, there were four randomized controlled trials. Two studies investigated the effects of naltrexone on amfetamine use disorder and two on methamfetamine use. Compared to placebo, the abstinence rate was increased significantly (p < 0.05) by naltrexone in one of two amfetamine studies, whereas there was no statistical difference in the only study reporting methamfetamine use. In one out of two amfetamine studies, naltrexone significantly attenuated either craving levels or subjective effects (e.g., 'want more,' 'like effect') relative to placebo (p < 0.05). Additionally, only in one of two methamfetamine studies did naltrexone produce a significant reduction (p < 0.05) in craving levels or attenuated subjective effects. Both amfetamine and methamfetamine studies showed good tolerability of naltrexone, with few adverse events seen. Conclusions: There is presently insufficient evidence to support the use of naltrexone in amfetamine and metamfetamine use disorders. There is a compelling need for high-quality studies to further evaluate the potential use of naltrexone.
Persistent Identifierhttp://hdl.handle.net/10722/276091
ISSN
2023 Impact Factor: 3.0
2023 SCImago Journal Rankings: 0.956
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLam, L-
dc.contributor.authorAnand, S-
dc.contributor.authorLi, X-
dc.contributor.authorTse, ML-
dc.contributor.authorZhao, J-
dc.contributor.authorChan, EWY-
dc.date.accessioned2019-09-10T02:55:46Z-
dc.date.available2019-09-10T02:55:46Z-
dc.date.issued2018-
dc.identifier.citationClinical Toxicology, 2018, v. 57 n. 4, p. 225-233-
dc.identifier.issn1556-3650-
dc.identifier.urihttp://hdl.handle.net/10722/276091-
dc.description.abstractIntroduction: Amfetamine and methamfetamine abuse remains a prevalent health problem, increasing the burden on healthcare. Naltrexone, a mu-opioid receptor antagonist, has been suggested as a promising treatment for amfetamine and methamfetamine use disorder. Objective: To review the current evidence for the efficacy and safety of naltrexone as a pharmacological treatment for amfetamine and methamfetamine use disorder. The primary outcome was defined as abstinence or reduction of use. Secondary outcomes were, attenuated 'positive' subjective effects (e.g., 'feel good,' 'craving,' etc.) of amfetamine or methamfetamine after naltrexone treatment, adverse events and physiological changes (e.g., blood pressure, heart rate). Methods: This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A systematic literature search was conducted on 2 April 2017, and updated on 31 March 2018. Records were retrieved from databases including PubMed, EMBASE Classic plus EMBASE 1980 via Ovid, and the databases were searched using keywords and/or headings: (naltrexone AND amfetamine AND dependence) OR (naltrexone AND amfetamine AND craving) OR (vivitrol AND amfetamine) OR (revia AND amfetamine) OR (naltrexone AND amfetamine) OR (naltrexone AND methamfetamine dependence) OR (naltrexone AND methamfetamine AND craving) OR (vivitrol AND methamfetamine) OR (revia AND methamfetamine) OR (naltrexone AND ice) OR (naltrexone AND crystal meth) OR (naltrexone AND methamfetamine). Studies investigating the effects of naltrexone on amfetamine or methamfetamine use were eligible for inclusion. All studies were rated as low risk of bias using the Cochrane tool for risk of bias. Results: Among 591 identified studies, there were four randomized controlled trials. Two studies investigated the effects of naltrexone on amfetamine use disorder and two on methamfetamine use. Compared to placebo, the abstinence rate was increased significantly (p < 0.05) by naltrexone in one of two amfetamine studies, whereas there was no statistical difference in the only study reporting methamfetamine use. In one out of two amfetamine studies, naltrexone significantly attenuated either craving levels or subjective effects (e.g., 'want more,' 'like effect') relative to placebo (p < 0.05). Additionally, only in one of two methamfetamine studies did naltrexone produce a significant reduction (p < 0.05) in craving levels or attenuated subjective effects. Both amfetamine and methamfetamine studies showed good tolerability of naltrexone, with few adverse events seen. Conclusions: There is presently insufficient evidence to support the use of naltrexone in amfetamine and metamfetamine use disorders. There is a compelling need for high-quality studies to further evaluate the potential use of naltrexone.-
dc.languageeng-
dc.publisherTaylor & Francis Inc. The Journal's web site is located at http://www.tandfonline.com/ictx-
dc.relation.ispartofClinical Toxicology-
dc.rightsAOM/Preprint Before Accepted: his article has been accepted for publication in [JOURNAL TITLE], published by Taylor & Francis. AOM/Preprint After Accepted: This is an [original manuscript / preprint] of an article published by Taylor & Francis in [JOURNAL TITLE] on [date of publication], available online: http://www.tandfonline.com/[Article DOI]. Accepted Manuscript (AM) i.e. Postprint This is an Accepted Manuscript of an article published by Taylor & Francis in [JOURNAL TITLE] on [date of publication], available online: http://www.tandfonline.com/[Article DOI].-
dc.subjectAmfetamine-
dc.subjectmethamfetamine-
dc.subjectnaltrexone-
dc.subjectsafety-
dc.subjecttolerability-
dc.titleEfficacy and safety of naltrexone for amfetamine and methamfetamine use disorder: A systematic review of randomized controlled trials.-
dc.typeArticle-
dc.identifier.emailLam, L: laml2911@hku.hk-
dc.identifier.emailLi, X: sxueli@hku.hk-
dc.identifier.emailZhao, J: jxzhao@hku.hk-
dc.identifier.emailChan, EWY: ewchan@hku.hk-
dc.identifier.authorityLi, X=rp02531-
dc.identifier.authorityChan, EWY=rp01587-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1080/15563650.2018.1529317-
dc.identifier.pmid30451013-
dc.identifier.scopuseid_2-s2.0-85063964707-
dc.identifier.hkuros303007-
dc.identifier.volume57-
dc.identifier.issue4-
dc.identifier.spage225-
dc.identifier.epage233-
dc.identifier.isiWOS:000463838400002-
dc.publisher.placeUnited States-
dc.identifier.issnl1556-3650-

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