The treatment of amphetamine or methamphetamine dependence poses a significant challenge, as there are currently no approved medications for this purpose. Moreover, there is a lack of studies examining the effectiveness of pharmacological treatments on important outcomes such as hospitalization and death.
A clinical study investigated the association between various pharmacotherapies and hospitalization and mortality outcomes in individuals diagnosed with amphetamine or methamphetamine use disorder. The study included residents aged 16 to 64 years without previous diagnoses of schizophrenia or bipolar disorder. Inpatient care, specialized outpatient care, sickness absence, and disability pension were analyzed.
The study compared periods of medication use with non-use, utilizing a method called PRE2DUP to minimize selection bias. The primary outcomes examined were hospitalization due to substance use disorder (SUD) and any hospitalization or death. The secondary outcome was all-cause mortality. The analysis employed within-individual models to compare medication use and non-use periods in the same individual, as well as between-individual analysis.
The study included 13,965 individuals, predominantly male, with a mean age of 34.4 years. Lisdexamphetamine was the only medication significantly associated with decreased risk across all three outcomes. It showed a decreased risk of SUD hospitalization, any hospitalization or death, and all-cause mortality. Methylphenidate use was also associated with lower all-cause mortality.
Benzodiazepine use was linked to increased risk for all three outcomes. Antidepressant and antipsychotic use showed a slight increase in the risk of SUD hospitalization and any hospitalization or death.
These findings are significant as they suggest that Lisdexamphetamine may benefit individuals with amphetamine or methamphetamine use disorders. However, further research through randomized clinical trials is necessary to confirm these associations. In contrast, the use of benzodiazepines was associated with poorer outcomes, highlighting the need for caution when prescribing these medications.
This study underscores the importance of investigating pharmacological treatments for amphetamine or methamphetamine dependence. The positive association between Lisdexamphetamine use and improved outcomes provides the impetus for future research and potential therapeutic options for individuals with these disorders.