Ahmadi Jamshid, Sahraian Ali, Biuseh Mehdi
Substance Abuse Research Center, Shiraz University of Medical Sciences, Chamran BLVD, Hafez Hospital, Shiraz, Iran.
Trials. 2019 Jul 30;20(1):468. doi: 10.1186/s13063-019-3554-6.
The purpose of this study was to compare the effect of 300 mg of bupropion and 8 mg of buprenorphine per day on the treatment of methamphetamine withdrawal cravings over a 2-week treatment interval.
Sixty-five methamphetamine-dependent men who met the DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders, 4th edition, text revision) criteria for methamphetamine dependence and withdrawal were randomly divided into two groups. Subjects randomly received 300 mg of bupropion or 8 mg of buprenorphine per day in a psychiatric ward. Of the 65 subjects, 35 (53.8%) received buprenorphine and 30 (46.2%) received bupropion. The subjects were assessed by using methamphetamine craving score, interview, and negative urine drug test.
There were no statistically significant differences between the two groups in regard to age, education, duration of methamphetamine dependency, marital status, employment, and income. The mean ages were 32.8 years (standard deviation (SD) = 7.26, range = 22 to 59) for the buprenorphine group and 32.21 years (SD = 8.45, range = 17 to 51) for the bupropion group. All 65 patients completed the 2-week study. Both medications were effective in the reduction of methamphetamine cravings. Reduction of craving in the buprenorphine group was significantly more than the bupropion group (P = 0.011). Overall, a significant main effect of day (P <0.001) and group (P = 0.011) and a non-significant group-by-day interaction (P >0.05) were detected.
The results support the safety and effectiveness of buprenorphine and bupropion in the treatment of methamphetamine withdrawal craving. Administration of 8 mg of buprenorphine per day can be recommended for the treatment of methamphetamine withdrawal cravings. We should note that it is to be expected that craving decreases over time without any medication. So the conclusion may not be that bupropion and buprenorphine both lower the craving. As the buprenorphine is superior to bupropion, only buprenorphine does so for sure.
Iranian Registry of Clinical Trials (IRCT) registration number: IRCT2015010320540N1 . Date registered: April 10, 2015.
本研究的目的是比较每天300毫克安非他酮和8毫克丁丙诺啡在为期2周的治疗期间对治疗甲基苯丙胺戒断渴求的效果。
65名符合《精神疾病诊断与统计手册》第四版修订版（DSM-IV-TR）中甲基苯丙胺依赖和戒断标准的甲基苯丙胺依赖男性被随机分为两组。受试者在精神科病房随机接受每天300毫克安非他酮或8毫克丁丙诺啡治疗。65名受试者中，35名（53.8%）接受丁丙诺啡治疗，30名（46.2%）接受安非他酮治疗。通过使用甲基苯丙胺渴求评分、访谈和尿液药物阴性检测对受试者进行评估。
两组在年龄、教育程度、甲基苯丙胺依赖持续时间、婚姻状况、就业和收入方面无统计学显著差异。丁丙诺啡组的平均年龄为32.8岁（标准差（SD）=7.26，范围=22至59岁），安非他酮组的平均年龄为32.21岁（SD = 8.45，范围=17至51岁）。所有65名患者均完成了为期2周的研究。两种药物在减少甲基苯丙胺渴求方面均有效。丁丙诺啡组的渴求减少显著多于安非他酮组（P = 0.011）。总体而言，检测到天数的显著主效应（P <0.001）和组间效应（P = 0.011），以及不显著的组×天数交互作用（P >0.05）。
结果支持丁丙诺啡和安非他酮治疗甲基苯丙胺戒断渴求的安全性和有效性。推荐每天服用8毫克丁丙诺啡治疗甲基苯丙胺戒断渴求。我们应该注意到，即使不使用任何药物，渴求也可能会随着时间的推移而减少。因此，结论可能并非安非他酮和丁丙诺啡都能降低渴求。由于丁丙诺啡优于安非他酮，只有丁丙诺啡肯定能降低渴求。
伊朗临床试验注册中心（IRCT）注册号：IRCT2015010320540N1。注册日期：2015年4月10日。
