Evaluating Reduced Use and Abstinence as Outcomes in Pharmacotherapy Trials for Stimulant Use Disorder

Do pharmacotherapies for stimulant use disorder show evidence of benefit when reduced use is evaluated as an outcome?In this meta-analysis of 12 randomized controlled trials, no medication demonstrated a significant benefit over placebo for abstinence. When reduced use was evaluated, pooled treatment effects remained nonsignificant; however, effect size estimates were consistently larger in magnitude than those observed for abstinence, and a positive signal for reduced cocaine use was observed for cabergoline in medication-specific analyses.Evaluating reduced stimulant use alongside abstinence may provide additional clinically relevant information for interpreting treatment effects in pharmacotherapy trials for stimulant use disorder.

Corresponding Author: Masoumeh Amin-Esmaeili, MD, MPH, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 550 Broadway, 2nd Floor, Rm 213H, Baltimore, MD 21205 (mamines1@jh.edu).

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