Emerging treatments

Cholinesterase inhibitors

Rivastigmine, a cholinesterase inhibitor, was studied in a randomized, double-blind, crossover study in a small number of methamphetamine patients. The low-dose rivastigmine showed a trend toward a reduced desire for methamphetamine.[118]

Transcranial magnetic stimulation

Meta-analysis data have shown reduction in cravings in patients with amphetamine use disorder. However, to date no abstinence efficacy has been demonstrated.[119][120]

Immunotherapy

Antibody therapy either as active immunization (for addiction) or passive immunization (for addiction or drug overdose) against methamphetamine is in early development.[121][122]

Riluzole

One small randomized controlled trial (RCT) lasting 12 weeks demonstrated promising effects using the glutamate antagonist riluzole in patients with methamphetamine use disorder. Riluzole was associated with a higher number of attended weekly visits, as well as with a lower weekly measured rate of positive methamphetamine urine tests, compared with placebo. Patients in the riluzole arm experienced significantly greater improvement on craving, withdrawal, and depression measures over the course of treatment.[123]

Mindfulness-based interventions

Mindfulness-based interventions for substance use disorders have been the subject of recent interest. According to one Cochrane review, the evidence is uncertain regarding the impact of mindfulness-based interventions on substance use disorder-related outcomes, although they may slightly reduce days with substance use at post-treatment and follow-up (4-10 months).[124] For methamphetamine use disorder, one RCT on mindfulness found positive results at 6-month follow-up regarding relapse rates, levels of craving, and symptoms of depression.[125]

Neurofeedback

In one preliminary RCT, neurofeedback (which uses real-time displays of brain activity, such as electroencephalography, to teach people how to regulate brain function) was associated with reduced addiction severity, and improved quality of life, in people with methamphetamine use disorder.[126]

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