Not All Medications for Addiction Are Created Equal
With regard to most medications for addiction, the fact is that not all medications are created equal. The most effective treatments for addiction are behavioral interventions. These approaches work to modify a patients’ expectancies and behaviors related to drug use while also increasing skills in coping with various life stressors. This may change in the near future as several drugs are currently under development for various drug addictions. When appropriate, medication assisted treatment (MAT) helps to treat the biological part of addiction. It aids the addict by removing the withdrawal symptoms as well as keeping them from getting high.
- Disulfiram (Antabuse): A form of aversion therapy this medication causes symptoms such as aggressive vomiting when a person drinks even a tiny amount of alcohol. The user must take disulfiram daily until they’re able to establish permanent self-control. The medication has also shown some promise as a treatment for cocaine addiction.
- Naltrexone (Revia, Depade, Vivitrol): When taken orally, this medication is most commonly used to reduce the craving and dependence of alcohol. When used intravenously it is used to reverse opiate overdose. It can also help overcome opioid addiction by blocking the drugs’ euphoric effects. Major side effects are nausea and abdominal pain.
- Varenicline (Campral, Chantix, Champix): Used primarily to treat nicotine addiction has also been shown to reduce alcohol cravings. It has minimal side effects.
- Methadone (Dolophine): An opioid used to treat pain, methadone acts chemically on the brain’s receptors for opiate drugs. When taken properly, there is no high in taking Methadone and therefore it doesn’t fuel addiction. Methadone has also shown promise as an effective treatment in the cocaine addiction.
- Buprenorphine (Suboxone): Another opiate medication that has the same effect as methadone but with some differences. A combination of buprenorphine and naloxone that when injected blocks the effects of pain-killing opiates and has a minimal risk of overdose. One major difference it has with methadone is that with methadone the dosage needs to be increased slowly and carefully over a period of time. With suboxone an optimal dose can be achieved in less than one week.
- Naltrexone: See above.
While there are no drugs currently approved for use in treating methamphetamine addiction, clinical trials are currently underway for several possible drugs. They include:
- Bupropion (Wellbutrin): This popular antidepressant inhibits the uptake of the neurotransmitter dopamine in the brain. It’s this property that may make bupropion useful for treating methamphetamine addiction in addition to depression.
- Sertraline (Zoloft): Mainly prescribed for major depressive disorders, this antidepressant blocks the uptake of the neurotransmitter serotonin which is also affected by methamphetamine.
- Lobeline: An alkaloid compound that affects the dopamine and nicotine systems in brain neurons and has been successful in reducing methamphetamine self-administration in rats.
- Aripiprazole (Abilify): A strong drug that is used primarily to treat schizophrenia and bipolar disorder. It acts on the dopamine receptors and may help reduce the stimulant effects of methamphetamine. It may also be used to prevent relapse.
- Carvediol, Clonidine, Atomexetine, Prazosin: These medications affect the neurotransmitters epinephrine and norepinephrine which have a role in the euphoric, motor activating, and rewarding effects of stimulants. These medications have been subject to animal and clinical studies and have been deemed safe. They are approved for clinical use for treating addiction of amphetamine/methamphetamine.
- Topiramate, Baclofen: These medications for addiction act on the neurotransmitter of the central nervous system GABA and glutamate. Early research has shown the medications decrease self-administration of cocaine and methamphetamine in animals.
- Modafinil, Perindopril, Rivastigmine: All three medications have shown promise in decreasing craving and methamphetamine seeking. All have antidepressant properties and may improve concentration and cognitive functions which can help patients obtain more benefit from counseling strategies and facilitate behavioral change.