Department of Family Medicine, University of California, Los Angeles, CA, USA.
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
Addiction. 2023 Apr;118(4):750-762. doi: 10.1111/add.16093. Epub 2022 Dec 12.
It is estimated that a majority of people who use psychostimulants, particularly methamphetamine (MA) and cocaine, experience withdrawal upon abstinence from sustained use. This review of clinical research reports the evidence regarding biomedical and behavioral treatments for psychostimulant withdrawal symptoms. It provides a framework for clinicians and scientists to increase impact on attenuating MA and cocaine withdrawal during initial and sustained abstinence. Articles reviewed included reports of controlled clinical trials (randomized or non-randomized) reporting at least one withdrawal symptom among the outcomes or specifically studying patients in withdrawal. Potential efficacy for MA withdrawal is noted for a few medications (mirtazapine, naltrexone, bupropion) and repetitive transcranial magnetic stimulation during acute (first week), early protracted (weeks 2-4) and late protracted (> 4 weeks) withdrawal phases. Topiramate shows mixed evidence of efficacy for cocaine withdrawal. In general, there is inconsistent signal for biomedical and behavioral treatments on MA and cocaine withdrawal.
据估计，大多数使用精神兴奋剂的人，特别是甲基苯丙胺（MA）和可卡因，在持续使用后戒断时会出现戒断症状。这篇临床研究综述报告了关于生物医学和行为治疗精神兴奋剂戒断症状的证据。它为临床医生和科学家提供了一个框架，以增加在初始和持续戒断期间减轻 MA 和可卡因戒断的影响。综述中包括了报告至少有一种戒断症状作为结果之一的对照临床试验（随机或非随机）的报告，或专门研究戒断患者的报告。在急性（第一周）、早期迁延性（第 2-4 周）和晚期迁延性（>4 周）戒断期，有几种药物（米氮平、纳曲酮、安非他酮）和重复经颅磁刺激对 MA 戒断有潜在疗效。托吡酯对可卡因戒断的疗效证据混杂。一般来说，生物医学和行为治疗对 MA 和可卡因戒断的效果信号不一致。
