Facultad de Medicina, Universidad de Piura, Lima, Peru.
Braz J Psychiatry. 2023 May-Jun;45(3):280-5. doi: 10.47626/1516-4446-2022-2979. Epub 2023 Mar 14.
We assessed the efficacy of cognitive behavioral therapy and bupropion compared to cognitive behavioral therapy alone for methamphetamine use disorder.
The selection criteria for this systematic review study with meta-analysis were randomized clinical trials on the efficacy of cognitive behavioral therapy and bupropion in the treatment for methamphetamine use disorder (assessed by urine metabolites). The search was conducted in PubMed, PubMed Central, LILACS, SciELO, Cochrane Library, SCOPUS, Google Scholar, Ovid Medline, Clinicaltrials.gov, and the International Clinical Trials Registry Platform. The primary outcome was relapse. Risk of bias was assessed with the RoB 2 tool. The results of each clinical trial were input into an Excel spreadsheet. We performed a meta-analysis using relative risk and a 95%CI.
Of the 597 initial articles (498 after removing duplicate records), five were included in the meta-analysis, with an aggregate sample of 539 patients. An overall relative risk of 0.91 (95%CI 0.78-1.05) was estimated for relapse.
Our study limitations included publication bias and heterogeneous populations. We found no evidence that cognitive behavioral therapy and bupropion reduced the risk of relapse compared to cognitive behavioral therapy and placebo.
我们评估了认知行为疗法联合安非他酮与单纯认知行为疗法治疗甲基苯丙胺使用障碍的疗效。
本系统评价和荟萃分析的纳入标准为评估认知行为疗法联合安非他酮治疗甲基苯丙胺使用障碍(通过尿液代谢物评估)疗效的随机临床试验。检索了 PubMed、PubMed Central、LILACS、SciELO、Cochrane Library、SCOPUS、Google Scholar、Ovid Medline、Clinicaltrials.gov 和国际临床试验注册平台。主要结局指标为复发。采用 RoB 2 工具评估偏倚风险。将每个临床试验的结果输入到 Excel 电子表格中。我们使用相对风险和 95%CI 进行荟萃分析。
在最初的 597 篇文章(去除重复记录后为 498 篇)中,有 5 篇文章纳入荟萃分析,总样本量为 539 例患者。复发的总体相对风险估计值为 0.91(95%CI 0.78-1.05)。
我们的研究存在发表偏倚和异质性人群的局限性。我们没有发现证据表明认知行为疗法联合安非他酮与认知行为疗法联合安慰剂相比,降低了复发的风险。