There are currently no medications that counteract the specific effects of methamphetamine or that prolong abstinence from and reduce the use of methamphetamine by an individual addicted to the drug. NIDA has made research on the development of medications to treat addiction to stimulants and other drugs a priority, and NIDA-funded researchers are investigating a number of pharmacological approaches for treating methamphetamine use disorder.
When developing drug treatments, researchers typically examine the impact of potential medications that have neurobiological effects that may counter the known physiological consequences of chronic methamphetamine use. They may also test medications that have shown promise in treating other addictions or other psychiatric disorders. The following targets and strategies have shown promise in animal or human studies related to methamphetamine use disorder:15,16
The neuroimmune system: Chronic methamphetamine use is associated with activation of microglia, cells that mediate inflammation in the central nervous system. Drugs like ibudilast and minocycline are being studied for their capacity to inhibit activation of microglia.
Cognitive enhancement: Chronic methamphetamine use is also associated with cognitive problems, such as impaired decision-making and impaired behavioral inhibition. Several drugs are under investigation for their potential to improve cognition in people who use methamphetamine.
Dopamine agonist treatment: Medications based on activation of the same receptors targeted by an addictive drug are effective in treating other addictions, such as the use of methadone or buprenorphine to treat opioid use disorder and the use of nicotine replacement to assist smoking cessation. Since methamphetamine targets the dopamine system, some stimulant medications that activate dopamine receptors (agonists) and that are often used to treat attention-deficit hyperactivity disorder (ADHD) are being investigated as potential medications to treat methamphetamine use disorder.
Other monoamine (serotonin, norepinephrine, dopamine) targets: Methamphetamine withdrawal symptoms are similar to depression, leading researchers to investigate the utility of antidepressants that act on the serotonin and norepinephrine systems for methamphetamine use disorder. Antipsychotic medications also act on the dopamine system and may have promise for ameliorating the effects of chronic methamphetamine use.
The opioid system: The euphoric effects of addictive drugs likely involve the opioid system. Candidate medications in this category include the opioid antagonist naltrexone (currently being studied in combination with the antidepressant bupropion) and the opioid partial agonist buprenorphine.
GABA and glutamate systems: Several medications targeting disruptions in the balance of excitation and inhibition (mediated by the neurotransmitters GABA and glutamate) are being investigated to treat methamphetamine use disorder.
Hormones: The hormones cholecystokinin-8 and oxytocin have both shown promise in reducing the rewarding properties of methamphetamine in animals.
Nonpharmacological treatments do not involve use of medications. Such therapies may instill behavioral changes by altering brain activity patterns (TMS), helping people learn how to monitor and control brain activity to curb symptoms of addiction (neurofeedback), or keeping drugs out of the brain (vaccines). Although further research is needed on these approaches, they may provide additional options for treatment providers and patients.
Transcranial Magnetic Stimulation: TMS is a noninvasive method of stimulating the brain using magnetic pulses for therapeutic purposes. Researchers are studying this approach as a treatment for substance use disorders, but this work is in very early stages.52
Neurofeedback: Neurofeedback (also called neurotherapy or neurobiofeedback) is a type of biofeedback that uses real-time displays of brain activity—most commonly electroencephalography—to teach people how to regulate their own brain function. In one study, neurofeedback to treatment for methamphetamine use disorder reduced addiction severity and improved mental health and overall quality of life.53
Vaccines and antibodies: Methamphetamine vaccines, which recruit the body’s immune system to keep the drug from entering the brain, are currently being tested in animals,54 and a human clinical trial is currently underway to test an immunologic agent called a monoclonal antibody, which binds to methamphetamine and neutralizes it before it can exert its effects.