Original Investigation

Mirtazapine for Methamphetamine Use Disorder

JAMA Psychiatry 10.1001/jamapsychiatry.2026.0159

April 01, 2026 at 11:00 AM EDT

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Is mirtazapine safe and effective for methamphetamine use disorder when delivered in routine clinical practice?In this double-blind, placebo-controlled randomized clinical trial of 344 adults with methamphetamine use disorder, 12 weeks of mirtazapine (30 mg/day) delivered in routine clinical practice produced a greater reduction in methamphetamine use days than placebo. There were no unexpected safety concerns from mirtazapine.Mirtazapine is safe and effective when used in routine clinical practice for reducing methamphetamine use in adults with methamphetamine use disorder.

Corresponding Author: Rebecca McKetin, PhD, National Drug and Alcohol Research Centre, Health Translation Hub, University of New South Wales Sydney, Sydney, 55 Botany St, Randwick NSW 2031, Australia (r.mcketin@unsw.edu.au).

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