Treatment of stimulant use disorder: A systematic review of reviews

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Title: Treatment of stimulant use disorder: A systematic review of reviews
Authors: Ronsley, ClaireNolan, SeonaidKnight, RodKlimas, Janet al.
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Date: 18-Jun-2020
Online since: 2020-11-24T11:59:40Z
Abstract: AIMS:Stimulant use disorder contributes to a substantial worldwide burden of disease, although evidence-based treatment options are limited. This systematic review of reviews aims to: (i) synthesize the available evidence on both psychosocial and pharmacological interventions for the treatment of stimulant use disorder; (ii) identify the most effective therapies to guide clinical practice, and (iii) highlight gaps for future study. METHODS:A systematic database search was conducted to identify systematic reviews and meta-analyses. Eligible studies were those that followed standard systematic review methodology and assessed randomized controlled trials focused on the efficacy of interventions for stimulant use disorder. Articles were critically appraised using an assessment tool adapted from Palmeteer et al. and categorized for quality as 'core' or 'supplementary' reviews. Evidence from the included reviews were further synthesized according to pharmacological or non-pharmacological management themes. RESULTS:Of 476 identified records, 29 systematic reviews examining eleven intervention modalities were included. The interventions identified include: contingency management, cognitive behavioural therapy, acupuncture, antidepressants, dopamine agonists, antipsychotics, anticonvulsants, disulfiram, opioid agonists, N-Acetylcysteine, and psychostimulants. There was sufficient evidence to support the efficacy of contingency management programs for treatment of stimulant use disorder. Psychostimulants, n-acetylcysteine, opioid agonist therapy, disulfiram and antidepressant pharmacological interventions were found to have insufficient evidence to support or discount their use. Results of this review do not support the use of all other treatment options. CONCLUSIONS:The results of this review supports the use of contingency management interventions for the treatment of stimulant use disorder. Although evidence to date is insufficient to support the clinical use of psychostimulants, our results demonstrate potential for future research in this area. Given the urgent need for effective pharmacological treatments for stimulant use disorder, high-quality primary research focused on the role of psychostimulant medications for the treatment of stimulant use disorder is needed.
Funding Details: European Commission Horizon 2020
Funding Details: MSFHR/St. Paul’s Foundation Scholar Award
Canada Research Chair in Addiction Medicine
CIHR New Investigator Award
Michael Smith Foundation for Health Research
St. Paul’s Hospital Foundation
University of British Columbia
Canadian Institutes of Health Research
Type of material: Journal Article
Publisher: Public Library of Science (PLoS)
Journal: PLoS ONE
Volume: 15
Issue: 6
Copyright (published version): 2020 the Authors
Keywords: CocaineSystematic reviewsPsychostimulantsMetaanalysisAmphetaminesPsychotherapyAntidepressants
DOI: 10.1371/journal.pone.0234809
Language: en
Status of Item: Peer reviewed
ISSN: 1932-6203
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