Amphetamine dependence

Abstract: In order to ascertain a cut-off score on the Severity of Dependence Scale (SDS) which is indicative of clinically significant amphetamine dependence, 327 regular amphetamine users were administered the SDS, along with the “Disorders resulting from the use of psychoactive substances” section of the Composite International Diagnostic Interview (CIDI) for DSM-III-R. Receiver operating characteristic (ROC) analysis was used in order to determine which cut-off score on the SDS allowed the best trade-off between sensitivity and specificity, when calibrated against the presence or absence of a DSM-III-R diagnosis of severe amphetamine dependence. Results suggest that the SDS has high diagnostic utility, and that a score of greater than four on the scale is indicative of problematic amphetamine use.

Abstract: Objective: Problems related to illegal amphetamine use have become a major public health issue in many developed countries. To date, evidence on the effectiveness of psychosocial treatments has remained modest, and no pharmacotherapy has proven effective for amphetamine dependence. Method: Individuals meeting DSM-IV criteria for intravenous amphetamine dependence (N=53) were randomly assigned to receive aripiprazole (15 mg/day), slow-release methylphenidate (54 mg/day), or placebo for 20 weeks. The study was terminated prematurely due to unexpected results of interim analysis. An intention-to-treat analysis was used. The primary outcome measure was the proportion of amphetamine-positive urine samples. Results: Patients allocated to aripiprazole had significantly more amphetamine-positive urine samples than patients in the placebo group (odds ratio=3.77, 95% CI=1.55–9.18), whereas patients who received methylphenidate had significantly fewer amphetamine-positive urine samples than patients who had received...