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Systematic Reviews
Published in: Systematic Reviews 1/2016

Open Access 01-12-2016 | Research

Efficacy and safety of psychostimulants for amphetamine and methamphetamine use disorders: a systematic review and meta-analysis

Authors: Meha Bhatt, Laura Zielinski, Lola Baker-Beal, Neera Bhatnagar, Natalia Mouravska, Phillip Laplante, Andrew Worster, Lehana Thabane, Zainab Samaan

Published in: Systematic Reviews | Issue 1/2016

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Abstract

Background

Amphetamine and methamphetamine use disorders are associated with severe health and social consequences. No pharmacological therapy has been approved for the treatment of these disorders. Psychostimulants can act as maintenance-like therapies for managing substance use among these patients.
The aim of this study is to evaluate the literature examining the efficacy and safety of psychostimulant agents for increasing abstinence and treatment retention among patients with amphetamine and methamphetamine use disorders.

Methods

We searched MEDLINE, EMBASE, PsycInfo, Cochrane Central, and CINAHL from inception to August 2016. Selection of studies, data extraction, and risk of bias assessment were conducted independently by two reviewers. We conducted meta-analyses to provide a pooled summary estimate for included trials and report the review according to PRISMA guidelines.

Results

We identified and selected 17 studies with 1387 participants. Outcome reporting across trials was inconsistent, and the overall quality of evidence was very low due to high risk of bias and indirectness. A meta-analysis of five trials (642 participants) found no effect of psychostimulants for end-of-study abstinence (odds ratio = 0.97, 95% confidence interval 0.65 to 1.45). Additionally, the pooled estimate from 14 studies (1184 participants) showed no effect of psychostimulants for treatment retention (odds ratio = 1.20, 95% confidence interval = 0.91 to 1.58). The incidence of serious adverse events did not differ between intervention and placebo groups based on qualitative reports from trials.

Conclusions

Quantitative analyses showed no effect of psychostimulants for sustained abstinence or treatment retention. We also identified the need for more rigorous studies in this research area with clinician and patient important outcomes.
Appendix
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Metadata
Title
Efficacy and safety of psychostimulants for amphetamine and methamphetamine use disorders: a systematic review and meta-analysis
Authors
Meha Bhatt
Laura Zielinski
Lola Baker-Beal
Neera Bhatnagar
Natalia Mouravska
Phillip Laplante
Andrew Worster
Lehana Thabane
Zainab Samaan
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Systematic Reviews / Issue 1/2016
Electronic ISSN: 2046-4053
DOI
https://doi.org/10.1186/s13643-016-0370-x

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