Authors: Cruickshank, Christopher¹; Montebello, Mark²; Dyer, Kyle³; Quigley, Allan⁴; Blaszczyk, Jozef⁵; Tomkins, Sally⁵; Shand, Diana⁴

Source: Drug and Alcohol Review, Volume 27, Number 3, May 2008 , pp. 326-333(8)

Publisher: Informa Healthcare

Abstract:

Introduction and Aims. As an antidepressant with sedative and anxiolytic properties, mirtazapine may be an appropriate pharmacotherapy for methamphetamine withdrawal. This study sought to examine whether mirtazapine improves retention and alleviates methamphetamine withdrawal symptoms in an out-patient setting. Design and Methods. An out-patient double-blind, randomised placebo-controlled trial of mirtazapine for the treatment of methamphetamine withdrawal was conducted (15 mg nocte for 2 days, 30 mg nocte for 12 days). Both groups were offered narrative therapy counselling. Measures recorded on days 0, 3, 7, 14 and 35 included: treatment retention, Amphetamine Cessation Symptoms Assessment, the Athens Insomnia Scale, the Brief Symptom Inventory, the Depression - Anxiety - Stress Scale (DASS), Severity of Dependence scale and the Opiate Treatment Index Drug Use subscale. Results. Thirty-one participants were recruited (18 placebo, 13 mirtazapine) and 52% completed the 2-week medication phase. No significant differences between the mirtazapine and placebo groups in retention, or any symptom measure were observed, except greater DASS - anxiety and longer sleep duration were measured at baseline among the mirtazapine group. Discussion and Conclusions. Results suggest that mirtazapine does not facilitate retention or recruitment in out-patient methamphetamine withdrawal treatment, although recruitment may have been insufficient to identify a significant treatment effect. The potential role of narrative therapy for methamphetamine dependent patients deserves further exploration. [Cruikshank CC, Montebello ME, Dyer KR, Quigley A, Blaszczyk J, Tomkins S, Shand D. A placebo-controlled trial of mirtazapine for the management of methamphetamine withdrawal. Drug Alcohol Rev 2008;27:326-333]

Keywords: Methamphetamine; mirtazapine; withdrawal; dependence

Document Type: Research article

DOI: http://dx.doi.org/10.1080/09595230801935672

Affiliations: 1: School of Medicine and Pharmacology, The University of Western Australia, Crawley, WA, Australia 2: National Drug and Alcohol Research Centre, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia,The Langton Centre, Surry Hills, NSW, Australia 3: School of Medicine and Pharmacology, The University of Western Australia, Crawley, WA, Australia,Drug and Alcohol Office, Mt Lawley, WA, Australia 4: Drug and Alcohol Office, Mt Lawley, WA, Australia 5: The Langton Centre, Surry Hills, NSW, Australia

Publication date: 2008-05-01

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