Journal of Substance Abuse Treatment
Volume 35, Issue 3 , Pages 334-342, October 2008

Symptoms and sleep patterns during inpatient treatment of methamphetamine withdrawal: A comparison of mirtazapine and modafinil with treatment as usual

  • Catherine McGregor, M.Psych., Ph.D.

      Affiliations

    • Monitoring, Evaluation and Research, Drug and Alcohol Office, Western Australia, Australia
    • Corresponding Author InformationCorresponding author. Catherine McGregor, M.Psych., Ph.D., Drug & Alcohol Office, 7 Field Street, Mount Lawley 6050 Western Australia. Tel.: +61 08 9370 0333; fax: +61 8 9271 5055.
    • ,
  • Manit Srisurapanont, M.D.

      Affiliations

    • Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Thailand
    • ,
  • Amanda Mitchell, R.N.

      Affiliations

    • Drug and Alcohol Services, South Australia, Australia
    • ,
  • Wendy Wickes, M.B.B.S. B.Sc.(Hon)

      Affiliations

    • Drug and Alcohol Services, South Australia, Australia
    • ,
  • Jason M. White, Ph.D.

      Affiliations

    • Discipline of Pharmacology, University of Adelaide, Australia
    • Pharmacotherapies Services, Drug and Alcohol Services, South Australia, Australia

Received 27 July 2007; received in revised form 21 December 2007; accepted 25 December 2007. published online 10 March 2008.

Abstract 

The safety and tolerability of modafinil (400 mg/day, n = 14) and mirtazapine (60 mg/day, n = 13) in inpatient methamphetamine withdrawal treatment were compared to a historical comparison group receiving treatment as usual (pericyazine, 2.5–10 mg/day, n = 22). Modafinil and mirtazapine were well tolerated, producing minimal positive subjective effects and no discontinuation effects in this open-label study. Side effects were mild and transient. Aches and pains were most commonly reported by participants receiving mirtazapine, whereas headache was reported by modafinil-treated participants. Modafinil-treated participants had a milder withdrawal syndrome as measured by the Amphetamine Cessation Symptom Assessment and less sleep disturbance in comparison to mirtazapine. Pericyazine was associated with a more severe withdrawal syndrome in comparison to mirtazapine and modafinil. Both modafinil and mirtazapine were safe and well tolerated in methamphetamine withdrawal treatment. However, these early findings of efficacy in symptom amelioration should be replicated in an adequately powered, randomized, placebo-controlled double-blind design.

Keywords: Methamphetamine, Withdrawal, Pharmacotherapy, Sleep

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 Work carried out at the Discipline of Pharmacology, University of Adelaide, 5th Floor, Medical School North, Frome Road, Adelaide, South Australia, Australia, 5005. Phone: +61 08 8303 5571, Fax: +61 08 8224 0685.

PII: S0740-5472(08)00004-4

doi:10.1016/j.jsat.2007.12.003

Journal of Substance Abuse Treatment
Volume 35, Issue 3 , Pages 334-342, October 2008

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