Affiliation:
1. Oregon Health and Science University, Department of Medicine, Division of General Internal Medicine and Geriatrics Addiction Medicine Section Portland OR USA
2. Department of Population and Data Sciences University of Texas Southwestern Medical Center Dallas TX USA
3. Department of Psychiatry and Behavioral Sciences University of Texas Health Science Center San Antonio San Antonio TX USA
4. Department of Psychiatry University of Texas Southwestern Medical Center Dallas TX USA
5. Department of Family Medicine University of California Los Angeles Los Angeles CA USA
6. Department of Psychiatry and Biobehavioral Sciences University of California Los Angeles Los Angeles CA USA
Abstract
AbstractBackground and AimsSocio‐cultural (gender) and biological (sex)‐based differences contribute to psychostimulant susceptibility, potentially affecting treatment responsiveness among women with methamphetamine use disorder (MUD). The aims were to measure (i) how women with MUD independently and compared with men respond to treatment versus placebo and (ii) among women, how the hormonal method of contraception (HMC) affects treatment responsiveness.DesignThis was a secondary analysis of ADAPT‐2, a randomized, double‐blind, placebo‐controlled, multicenter, two‐stage sequential parallel comparison design trial.SettingUnited States.ParticipantsThis study comprised 126 women (403 total participants); average age = 40.1 years (standard deviation = 9.6) with moderate to severe MUD.InterventionsInterventions were combination intramuscular naltrexone (380 mg/3 weeks) and oral bupropion (450 mg daily) versus placebo.MeasurementsTreatment response was measured using a minimum of three of four negative methamphetamine urine drug tests during the last 2 weeks of each stage; treatment effect was the difference between weighted treatment responses of each stage.FindingsAt baseline, women used methamphetamine intravenously fewer days than men [15.4 versus 23.1% days, P = 0.050, difference = −7.7, 95% confidence interval (CI) = −15.0 to −0.3] and more women than men had anxiety (59.5 versus 47.6%, P = 0.027, difference = 11.9%, 95% CI = 1.5 to 22.3%). Of 113 (89.7%) women capable of pregnancy, 31 (27.4%) used HMC. In Stage 1 29% and Stage 2 5.6% of women on treatment had a response compared with 3.2% and 0% on placebo, respectively. A treatment effect was found independently for females and males (P < 0.001); with no between‐gender treatment effect (0.144 females versus 0.100 males; P = 0.363, difference = 0.044, 95% CI = −0.050 to 0.137). Treatment effect did not differ by HMC use (0.156 HMC versus 0.128 none; P = 0.769, difference = 0.028, 95% CI −0.157 to 0.212).ConclusionsWomen with methamphetamine use disorder receiving combined intramuscular naltrexone and oral bupropion treatment achieve greater treatment response than placebo. Treatment effect does not differ by HMC.
Funder
Agency for Healthcare Research and Quality
National Institute on Drug Abuse
U.S. Department of Health and Human Services
Subject
Psychiatry and Mental health,Medicine (miscellaneous)
Cited by
1 articles.
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