ArticleJournal of addiction medicine
Utilizing a Two-stage Design to Investigate the Safety and Potential Efficacy of Monthly Naltrexone Plus Once-daily Bupropion as a Treatment for Methamphetamine Use Disorder.
Article in Journal of addiction medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.
- The ASAM/AAAP Clinical Practice Guideline on the Management of Stimulant Use Disorder.Journal of addiction medicineGuideline
- Early Change in Depressive Symptom Severity With Naltrexone-Bupropion Combination and Its Association With Reduction in Methamphetamine Use in ADAPT-2 Trial.The Journal of clinical psychiatry · 2025Trial
- Extended observation of reduced methamphetamine use with combined naltrexone plus bupropion in the ADAPT-2 trial.Addiction (Abingdon, England) · 2024Trial
- Naltrexone plus bupropion reduces cigarette smoking in individuals with methamphetamine use disorder: A secondary analysis from the CTN ADAPT-2 trial.Journal of substance use and addiction treatment · 2023Trial
- Bupropion and Naltrexone in Methamphetamine Use Disorder.The New England journal of medicine · 2021Trial
- Extended-release naltrexone for methamphetamine dependence among men who have sex with men: a randomized placebo-controlled trial.Addiction (Abingdon, England) · 2018Trial
- Baseline Moderators of Response to Naltrexone and Bupropion in the Treatment of Methamphetamine Use Disorder: An ADAPT-2 Study.Journal of addiction medicineTrial
- Stakeholder-informed recommendations for patient-centered medication service delivery for stimulant use disorder: a qualitative study.Addiction science & clinical practice · 2026Article
- Case Report: Unusual oral cavity changes associated with methamphetamine abuse.Frontiers in public health · 2025Article
- High suicidality predicts overdose events among people with substance use disorder: A latent class analysis.Frontiers in public health · 2023Article
- Suicidality as a Predictor of Overdose among Patients with Substance Use Disorders.Journal of clinical medicine · 2022Article
- Responding to global stimulant use: challenges and opportunities.Lancet (London, England) · 2019Review
- Medications for substance use disorders (SUD): emerging approaches.Expert opinion on emerging drugs · 2017Review
- Medication Adherence Monitoring Using Smartphone Video Dosing in an Open-label Pilot Study of Monthly Naltrexone Plus Once-daily Bupropion for Methamphetamine Use Disorder: Feasibility and Acceptability.Journal of addiction medicineArticle
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 2 countries.
Funding
Abstract
objectivesThis 2-stage open-label pilot study evaluated the safety and potential efficacy of naltrexone + bupropion as a pharmacotherapy for methamphetamine (MA) use disorder.
methodsThe study was conducted in 2 stages of recruitment across 3 sites; 20 participants were enrolled in stage 1 and 29 participants were enrolled in stage 2. Eight weeks of open-label pharmacotherapy with a combination of extended-release injectable naltrexone (XR-NTX; Vivitrol) plus extended-release oral bupropion (BRP; Wellbutrin XL) were provided with a smartphone-assisted medication adherence platform. Participants met Diagnostic and Statistical Manual of Mental Disorders, 5th Edition criteria for severe MA use disorder, self-reported ≥20 days of MA use in the 30 days prior to consent, and submitted 3 MA-positive urine drug screens (UDS) out of 4 collected during screening. Participants attended clinic twice weekly for observed BRP dosing, UDS testing, assessments, and medical management; XR-NTX was administered at weeks 1 and 5. A BRP taper and follow-up visit occurred in week 9.
resultsAnalyses evaluated effects of XR-NTX + BRP to determine the number of "responders" according to a statistically predefined response criterion (6 of 8 MA-negative UDS during the last 4 weeks of medication). The 2-stage design required that stage 1 yield ≥3 responders to continue to stage 2; 11 of the 49 participants met responder criteria across both stages (5 in stage 1, 6 in stage 2).
conclusionsUnder the statistical analysis plan, study "success" required ≥9 responders. With 11 responders, the study demonstrated sufficient potential of naltrexone plus bupropion as a combination pharmacotherapy for MA use disorder to warrant further study.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.