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Table 1 Individual study characteristics (17 included studies)

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

Author, year and country Diagnosis/sample details Study length Intervention/dose Number of participants (% male) Mean age by treatment group (years), SD Summary of substance use outcomes
Anderson, A 2012
USA [35]
MA dependence/adults with any frequency of use 16 weeks Modafinil/200 or 400 mg once daily on awakening 210 (59.1% male) Modafinil 200 mg 37.6 (8.9)
Modafinil 400 mg 40 (8.4)
Placebo 39.4 (8.6)
No significant difference in MA non-use weeks (p = 0.53, GEE), MA non-use days (p = 0.63, overall Kruskal–Wallis) or terminal abstinence (Fisher’s exact p = 0.84) between modafinil groups and placebo
Anderson, A 2015
USA
[12]
MA dependence/low frequency users (≤29 of past 30 days) 12 weeks Bupropion/150 mg twice daily 204 (65% male) Total sample 39.3 (NR) Treatment success, defined as ≥2 negative urines in weeks 11 and 12, was achieved by 14% (14/100) of the bupropion group and 19% (20/104) of the placebo group (chi-square, p = 0.32)
Das, M 2010
USA
[21]
MA dependence/among men having sex with men 12 weeks Bupropion/150 mg 1 pill every morning for 1 week, then 2 150 mg pills every morning thereafter 30 (100% male) Bupropion 38.1 (2)
Placebo 33.3 (3)
Reductions in meth-metabolite-positive urines were similar in the bupropion and placebo groups (normal-logistic model, p = 0.63)
Elkashef, A 2008
USA
[22]
MA dependence/adults with any frequency of use 18 weeks Bupropion/150 mg once daily for 3 days, then increased to 300 mg daily (1 tablet twice a day) for 11 weeks 151 (67% male) Bupropion 36.2 (9.2)
Placebo 35.7 (8.4)
No significant improvement for percentage of participants with MA-free study weeks in the bupropion group (week 1 = 25%; week 12 = 54%) compared to placebo (week 1 = 29%; week 12 = 44%)
(GEE, p = 0.09)
Galloway, G 2011
USA
[23]
MA dependence/adults with any frequency of use 8 weeks Dextroamphetamine/60 mg daily—single dose on the first day and as 2 equally divided doses on subsequent days 60 (56.7% male) Dextroamphetamine 37 (7.2)
Placebo 37.5 (7.2)
Out of 16 urine tests over the 8-week trial period, the dextroamphetamine group had 2.9 ± 4.3 MA-negative results and the placebo group had 3.2 ± 5.0 MA-negative results (Mann–Whitney U test: W = 441, p = 0.894)
Heinzerling, K 2010
USA
[24]
MA dependence/adults with any frequency of use 14 weeks Modafinil/200 mg per day (taken in the morning) for the first 3 days of the study, followed by an increase to 400 mg per day (in the morning) 71 (70.4% male) Modafinil 39.1 (11.1)
Placebo 37.8 (10.1)
No significant association between treatment group assignment and the probability of providing MA-free urine drug screens across the treatment period (OR = 0.78, 95% CI 0.39–1.56, p = 0.49 for modafinil relative to placebo)
Heinzerling, K 2013
USA
[33]
MA abuse or dependence/adolescent low frequency users (≤18 of past 30 days) 8 weeks Bupropion/150 mg twice daily 19 (47.4% male) Bupropion 17.5 (1.6)
Placebo 17.7 (1.1)
Mean number of twice weekly MA-negative urine screens in bupropion group = 5.0 and placebo group = 8.9 (p = 0.043)
Heinzerling, K 2014
USA
[13]
MA dependence/low frequency users (≤29 of past 30 days) 16 weeks Bupropion/150 mg once daily for 3 days, then 150 mg twice daily 84 (80.9% male) Bupropion 38.6 (10.1)
Placebo 38.1 (10.3)
No significant difference in the proportion of participants with MA abstinence during weeks 11 and 12, for bupropion = 12/41 and placebo = 6/43 (p = 0.087)
Konstenius, M
2010
Sweden
[25]
Amphetamine dependence/among individuals with ADHD 13 weeks Methylphenidate/18 mg starting dose titrated over period of 10 days to the maximum dose of 72 mg 24 (75% male) Methylphenidate 34.6 (10.1)
Placebo 39.7 (9.8)
No significant difference in proportion of positive urine screens during the study between methylphenidate (mean = 10.6, SD = 8.8) and placebo groups (mean = 8.6, SD = 7.8) (p = 0.472)
Konstenius, M 2014
Sweden
[26]
Amphetamine dependence/among incarcerated individuals with ADHD 24 weeks Methylphenidate/18 mg starting dose titrated over a period of 19 days (with 36 mg increments every 3 days), to a maximum dose of 180 mg/day 54 (100% male) Methylphenidate 41 (7.5)
Placebo 42 (11.7)
Significant difference in proportion of drug-negative urines in methylphenidate group (MD = 23%, n = 27) compared to placebo group (MD = 16%, n = 27) p = 0.047
Ling, W 2014
USA
[27]
MA dependence/adults with any frequency of use 14 weeks Methylphenidate/18 mg daily for week 1, 36 mg for week 2 and 54 mg for weeks 3–10 110 (81.8% male) Methylphenidate 38.7 (9.8)
Placebo 39.5 (10.4)
Methylphenidate group was less likely to be MA positive compared to placebo group at week 14 (OR = 0.18, p = 0.025)
Longo, M 2009
Australia
[29]
MA dependence/adults with any frequency of use 12 weeks Dexamphetamine/20 mg/day starting dose increased by 10 mg daily as required until stabilized or to a maximum of 110 mg/day (stabilized over 14 days) 49 (61.2% male) Dexamphetamine 31.9 (4.5)
Placebo 31.9 (5.6)
Significant decrease of MA concentration in hair for both groups (p < 0.0001) but no significant difference between groups (p value not provided)
Miles, SW
2013
Finland and New Zealand
[28]
Amphetamine or MA dependence/adults with any frequency of use 22 weeks Methylphenidate/18 mg/day for the first week, 36 mg daily for the second week and 54 mg daily thereafter until the end of week 22 78 (62.8% male) Methylphenidate 38.9 (9.2)
Placebo 34 (8.5)
No significant difference in mean percentage of positive urine tests over the course of the study between methylphenidate (mean = 89%, SD = 19) and placebo (mean = 90%, SD = 14) groups (p = 0.89)
Rezaei, F 2015
Iran
[31]
MA dependence/adults with any frequency of use 10 weeks Methylphenidate/18 mg/day during the first week and 36 mg/day during the second week and then received 54 mg/day for the remaining 8 weeks 56 (73.2% male) Methylphenidate 35.6 (6.9)
Placebo 34.7 (9.1)
Methylphenidate group had significantly less MA-positive urine tests compared to placebo at week 10 (p = 0.03)
Shearer, J 2009
Australia
[34]
MA dependence/regular users (2–3 days of use per week or more) 22 weeks Modafinil/200 mg/day 80 (62.5% male) Modafinil 35.8 (6.9)
Placebo 36.1 (9.1)
No significant difference in proportion of stimulant-positive weekly urine drug screens between groups (chi-square = 17.10, p = 0.07)
Shoptaw, S
2008
USA
[30]
MA dependence/adults with any frequency of use 12 weeks Bupropion/150 mg per day for days 1–3, followed by an increase to 300 mg per day (one 150 mg capsule taken twice daily) until week 12 73 (64.4% male) Bupropion 34.6 (10.6)
Placebo 34.6 (10.0)
No significant difference between treatment groups in the mean MA-free urine screens or the probability of achieving a MA-free week in a GEE model (chi-square = 0.004, degrees of freedom = 71, p = 0.95)
Tiihonen, J
2007
Finland
[32]
Amphetamine or MA dependence/among intravenous users 20 weeks Methylphenidate/18 mg/day for the first week, 36 mg/day for the second week, and 54 mg/day thereafter 34 (70.6% male) Methylphenidate 35.1 (7.9)
Placebo 40 (10.1)
Significantly fewer positive urine samples in methylphenidate group compared to placebo group (OR = 0.42, 95% CI = 0.24–0.72; z = −3.14, p = 0.002)
  1. All studies used an inactive placebo pill of the same dosage as the intervention for the control group. The substance use outcomes are summarized as they are reported in the individual studies
  2. MA methamphetamine, SD standard deviation, NR not reported, GEE generalized estimating equations, OR odds ratio, CI confidence interval, MD mean difference