Antidepressant Shows Promise as Treatment for Meth Addiction

A medication assisted treatment option has never been available for methamphetamine addiction, because no drug has ever been approved for the condition.

A randomized clinical trial conducted in Australia and published in JAMA Psychiatry tested whether the gap is potentially narrowing. The researchers used a drug already familiar in mental health care: the antidepressant mirtazapine.

It has always been clinically challenging to do withdrawal management for stimulants. There’s rarely danger with methamphetamine withdrawal in comparison to alcohol or benzodiazepine withdrawal.

It does bring about severe depression, insomnia and intense cravings. Those symptoms may cause one to relapse in the weeks after detox ends.

What the Australian Trial Found

The clinical trial conducted an evaluation of mirtazapine as a pharmacotherapy for methamphetamine use disorder. Researchers measured whether the antidepressant could reduce methamphetamine use among people with a dependency on the drug.

The results add to a growing but still limited evidence base that suggests mirtazapine may reduce meth use for some patients. The study’s authors have cautioned that larger and longer trials are needed before the approach could change practice.

Why Meth and Depression Travel Together

People with pre-existing depression often report using stimulants to self-medicate. Clinically, untangling which came first matters less than the treatment reality: addressing one condition while ignoring the other tends to fail.

That interconnection is the rationale for dual diagnosis care, and it runs straight through detox.

Depression during meth withdrawal is one of the symptoms clinicians watch most closely during medical detox, both because of relapse risk and because withdrawal-phase depression can escalate to suicidal thinking.

How Mirtazapine Could Fit Into Treatment

Mirtazapine is an antidepressant that affects serotonin and other neurotransmitters. Many doctors prescribe it for depression already.

With the drug already being approved and widely used for depression, researchers could evaluate it as a pharmacotherapy for methamphetamine use disorder without having to wait for the development of a new compound.

Medication-Assisted Treatment for Meth Remains Unproven

The evidence-based standard for methamphetamine use disorder remains structured behavioral treatment. This involves contingency management, cognitive behavioral therapy and psychiatric care for co-occurring depression.

Medical detox for meth centers on supervised withdrawal management, symptom monitoring and planning for continued treatment after stabilization. Detox alone does not treat the underlying disorder.

The trial nonetheless points somewhere the field has wanted to explore for many years, a pharmacological tool for stimulant addiction.

Finding Medical Detox for Meth

Anyone in need of help with methamphetamine addiction should look for medically supervised detox programs that can manage withdrawal safely. The program should also connect you to ongoing treatment.

You can search detox programs near you through the Detox.com directory, or call 800-996-6135Sponsored to speak with someone about medical detox and medication-assisted treatment options.