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Bupropion for treatment of amphetamine-type stimulant use disorder: A systematic review and meta-analysis of placebo-controlled randomized clinical trials. | LitMetric

Bupropion for treatment of amphetamine-type stimulant use disorder: A systematic review and meta-analysis of placebo-controlled randomized clinical trials.

Drug Alcohol Depend

Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada; Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada. Electronic address:

Published: December 2023

AI Article Synopsis

  • This meta-analysis evaluated the effectiveness and safety of bupropion for treating amphetamine-type stimulant use disorder (ATSUD) by examining data from eight placebo-controlled randomized clinical trials involving 1,239 participants.
  • Bupropion was found to significantly reduce ATS use and craving, particularly in male participants and when the treatment duration was extended to 12 weeks.
  • Despite showing modest benefits, the evidence quality was rated very low, indicating a need for further research to better understand who may benefit from bupropion as a treatment option for ATSUD.

Article Abstract

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.

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http://dx.doi.org/10.1016/j.drugalcdep.2023.111018DOI Listing

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Bupropion for treatment of amphetamine-type stimulant use disorder: A systematic review and meta-analysis of placebo-controlled randomized clinical trials.

Drug Alcohol Depend

December 2023

Research Centre, Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Québec, Canada; Department of Psychiatry and Addictology, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada. Electronic address:

Article Synopsis
  • This meta-analysis evaluated the effectiveness and safety of bupropion for treating amphetamine-type stimulant use disorder (ATSUD) by examining data from eight placebo-controlled randomized clinical trials involving 1,239 participants.
  • Bupropion was found to significantly reduce ATS use and craving, particularly in male participants and when the treatment duration was extended to 12 weeks.
  • Despite showing modest benefits, the evidence quality was rated very low, indicating a need for further research to better understand who may benefit from bupropion as a treatment option for ATSUD.
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