PMID- 37979478
OWN - NLM
STAT- MEDLINE
DCOM- 20231218
LR  - 20231218
IS  - 1879-0046 (Electronic)
IS  - 0376-8716 (Linking)
VI  - 253
DP  - 2023 Dec 1
TI  - Bupropion for treatment of amphetamine-type stimulant use disorder: A systematic 
      review and meta-analysis of placebo-controlled randomized clinical trials.
PG  - 111018
LID - S0376-8716(23)01256-5 [pii]
LID - 10.1016/j.drugalcdep.2023.111018 [doi]
AB  - BACKGROUND: This meta-analysis (PROSPERO-ID: CRD42022362962), pooled effect 
      estimates of outcomes, from placebo-controlled randomized clinical trials (RCTs) 
      examining bupropion efficacy and safety for amphetamine-type stimulant use 
      disorder (ATSUD) treatment. METHOD: Electronic databases were searched for 
      records published to October 31st, 2022, including MEDLINE, CINAHL, PsycINFO, EBM 
      Reviews, EMBASE, PubMed, Web of Science, trial registries. Inclusion criteria 
      were RCTs comparing bupropion to placebo in ATSUD. Cochrane RoB2 tool and GRADE 
      evidence certainty assessment were employed. Outcomes included amphetamine-type 
      stimulant (ATS) use by urinalysis, retention in treatment, treatment adherence, 
      ATS craving, addiction severity, depressive symptom severity, drop-out following 
      adverse events (AEs), and serious AEs. Random-effect meta-analysis was conducted 
      presenting standardized mean difference (SMD), risk ratio (RR), and risk 
      difference (RD). RESULTS: Eight RCTs (total N=1239 participants) were included. 
      Bupropion compared to placebo was associated with reduced ATS use (RR: 0.90; 95% 
      CI: 0.84, 0.96), end-of-treatment ATS craving (SMD: -0.38; 95%CI: -0.63, -0.13), 
      and adherence (RR: 0.91; 95%CI: 0.84, 0.99). Subgroup analysis showed greater 
      reduction in ATS use with longer trial duration (12 weeks) (RR: 0.85; 95%CI: 
      0.78, 0.93) and greater reduction in end-of-treatment ATS craving in studies with 
      mixed ATS use frequency (SMD: -0.46; 95%CI: -0.70, -0.22) and male-only samples 
      (SMD: -1.26; 95%CI: -1.87, -0.65). CONCLUSION: Bupropion showed a significant 
      modest reduction in ATS use and ATS craving (both rated as very low-quality 
      evidence), larger in males (craving), and with longer treatment (ATS use). These 
      results may inform future studies. More research is warranted on who might 
      benefit from bupropion as ATSUD treatment.
CI  - Copyright (c) 2023 Elsevier B.V. All rights reserved.
FAU - Bakouni, Hamzah
AU  - Bakouni H
AD  - Research Centre, Centre Hospitalier de l'Universite de Montreal 
      (CRCHUM), Montreal, Quebec, Canada; Department of Psychiatry and Addictology, 
      Faculty of Medicine, Universite de Montreal, Montreal, Quebec, Canada.
FAU - Sharafi, Heidar
AU  - Sharafi H
AD  - Research Centre, Centre Hospitalier de l'Universite de Montreal 
      (CRCHUM), Montreal, Quebec, Canada; Department of Psychiatry and Addictology, 
      Faculty of Medicine, Universite de Montreal, Montreal, Quebec, Canada.
FAU - Bahremand, Arash
AU  - Bahremand A
AD  - Research Centre, Centre Hospitalier de l'Universite de Montreal 
      (CRCHUM), Montreal, Quebec, Canada; Department of Psychiatry and Addictology, 
      Faculty of Medicine, Universite de Montreal, Montreal, Quebec, Canada.
FAU - Drouin, Sarah
AU  - Drouin S
AD  - Research Centre, Centre Hospitalier de l'Universite de Montreal 
      (CRCHUM), Montreal, Quebec, Canada; Department of Psychiatry and Addictology, 
      Faculty of Medicine, Universite de Montreal, Montreal, Quebec, Canada.
FAU - Ziegler, Daniela
AU  - Ziegler D
AD  - Centre hospitalier de l'Universite de Montreal (CHUM), Montreal, Quebec, Canada.
FAU - Bach, Paxton
AU  - Bach P
AD  - University of British Columbia, Department of Medicine; British Columbia Centre 
      on Substance Use, Vancouver, British Columbia, Canada.
FAU - Le Foll, Bernard
AU  - Le Foll B
AD  - Department of Pharmacology and Toxicology, Faculty of Medicine, University of 
      Toronto, Toronto, Ontario, Canada; Department of Family and Community Medicine, 
      Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada; Department 
      of Psychiatry, University of Toronto, Toronto, Ontario, Canada; Dalla Lana School 
      of Public Health, University of Toronto, Toronto, Ontario, Canada; Translational 
      Addiction Research Laboratory, Campbell Family Mental Health Research Institute, 
      Center for Addiction and Mental Health, Toronto, Ontario, Canada; Waypoint 
      Research Institute, Waypoint Centre for Mental Health 
      Care, Penetanguishene, Ontario, Canada.
FAU - Schutz, Christian G
AU  - Schutz CG
AD  - British Columbia Mental Health and Substance Use Services, Provincial Health 
      Service Authority, University of British Columbia, Vancouver, Vancouver, British 
      Columbia, Canada.
FAU - Tardelli, Vitor
AU  - Tardelli V
AD  - Translational Addictions Research Lab (TARL), Centre for Addiction and Mental 
      Health, University of Toronto, Toronto, Canada; Department of Psychiatry, 
      Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
FAU - Ezard, Nadine
AU  - Ezard N
AD  - St Vincent's Hospital Sydney Alcohol and Drug Service, Darlinghurst, Australia; 
      The National Centre for Clinical Research on Emerging Drugs (NCCRED), The 
      University of New South Wales (UNSW), Sydney, Australia; National Drug and 
      Alcohol Research Centre (NDARC), University of New South 
      Wales, Randwick, Australia.
FAU - Siefried, Krista
AU  - Siefried K
AD  - St Vincent's Hospital Sydney Alcohol and Drug Service, Darlinghurst, Australia; 
      The National Centre for Clinical Research on Emerging Drugs (NCCRED), The 
      University of New South Wales (UNSW), Sydney, Australia; National Drug and 
      Alcohol Research Centre (NDARC), University of New South 
      Wales, Randwick, Australia.
FAU - Jutras-Aswad, Didier
AU  - Jutras-Aswad D
AD  - Research Centre, Centre Hospitalier de l'Universite de Montreal 
      (CRCHUM), Montreal, Quebec, Canada; Department of Psychiatry and Addictology, 
      Faculty of Medicine, Universite de Montreal, Montreal, Quebec, Canada. Electronic 
      address: didier.jutras-aswad@umontreal.ca.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20231104
PL  - Ireland
TA  - Drug Alcohol Depend
JT  - Drug and alcohol dependence
JID - 7513587
RN  - 01ZG3TPX31 (Bupropion)
RN  - 0 (Amphetamines)
SB  - IM
MH  - Male
MH  - Humans
MH  - *Bupropion/adverse effects
MH  - Randomized Controlled Trials as Topic
MH  - *Substance-Related Disorders/drug therapy
MH  - Amphetamines/therapeutic use
OTO - NOTNLM
OT  - Amphetamine
OT  - Amphetamine use disorder
OT  - Bupropion
OT  - Meta-analysis
OT  - Methamphetamine
OT  - Pharmacotherapy
OT  - Treatment
COIS- Declaration of Competing Interest PB is the site PI for upcoming trial on 
      psychostimulants for the treatment of methamphetamine use disorder. CGS is a 
      consultant at Clearmind Medicine. NE has received funding from the Australian 
      National Health and Medical Research Council (NHMRC) to conduct a study examining 
      lisdexamfetamine for the treatment of MAUD (APP1109466). KS has received funding 
      from the National Centre for Clinical Research on Emerging Drugs (NCCRED) to 
      conduct a pilot study of lisdexamfetamine for methamphetamine withdrawal (NCCRED 
      is funded by the Australian Government Department of Health [4-EH8ULD4]). BLF has 
      obtained funding from Pfizer Inc. (GRAND Awards, including salary support) for 
      investigator-initiated projects. BLF has obtained funding from Indivior for a 
      clinical trial sponsored by Indivior. BLF has in-kind donations of cannabis 
      products from Aurora Cannabis Enterprises Inc. and study medication donations 
      from Pfizer Inc. (varenicline for smoking cessation) and Bioprojet Pharma. BLF 
      was also provided a coil for a Transcranial magnetic stimulation (TMS) study from 
      Brainsway. BLF has obtained industry funding from Canopy Growth Corporation 
      (through research grants handled by the Centre for Addiction and Mental Health 
      and the University of Toronto), Bioprojet Pharma, Alcohol Countermeasure Systems 
      (ACS), Alkermes, and Universal Ibogaine. BLF has participated in a session of a 
      National Advisory Board Meeting (Emerging Trends BUP-XR) for Indivior Canada and 
      has been a consultant for Shinogi. DJA receives study material from Cardiol 
      Therapeutics and Exka for clinical trials funded by the Quebec Ministry of Health 
      and Social Services. All other authors declare no conflict of interest.
EDAT- 2023/11/19 09:42
MHDA- 2023/12/18 06:42
CRDT- 2023/11/18 18:12
PHST- 2023/08/22 00:00 [received]
PHST- 2023/10/25 00:00 [revised]
PHST- 2023/10/26 00:00 [accepted]
PHST- 2023/12/18 06:42 [medline]
PHST- 2023/11/19 09:42 [pubmed]
PHST- 2023/11/18 18:12 [entrez]
AID - S0376-8716(23)01256-5 [pii]
AID - 10.1016/j.drugalcdep.2023.111018 [doi]
PST - ppublish
SO  - Drug Alcohol Depend. 2023 Dec 1;253:111018. doi: 
      10.1016/j.drugalcdep.2023.111018. Epub 2023 Nov 4.