Evidence map›Paper›PMID 39432105›Full record

SynthesisPsychopharmacology2024

Exploring the efficacy of cholinergic agents for the treatment of psychostimulant use disorder: a systematic review.

Nicolas Salloum, Margot Chouchana, Romain Icick, Vanessa Bloch, Stéphanie Daumas, Salah El Mestikawy, Florence Vorspan, Virgile Clergue-Duval

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Psychopharmacology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Nicolas Salloum *Département de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, GHU APHP.Nord - Université Paris Cité, 200 Rue du Faubourg Saint-Denis, Paris, 75010, France.
Margot Chouchana *Service de Pharmacie Hospitalière, Site Lariboisière Fernand-Widal, GHU APHP.Nord - Université Paris Cité, 200 Rue du Faubourg Saint- Denis, Paris, 75010, France.
Romain IcickDépartement de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, GHU APHP.Nord - Université Paris Cité, 200 Rue du Faubourg Saint-Denis, Paris, 75010, France.
Vanessa BlochService de Pharmacie Hospitalière, Site Lariboisière Fernand-Widal, GHU APHP.Nord - Université Paris Cité, 200 Rue du Faubourg Saint- Denis, Paris, 75010, France.
Stéphanie DaumasFHU Network of Research in Substance Use Disorders (NOR-SUD), 4 Avenue de l'observatoire, Paris, 75006, France.
Salah El MestikawyFHU Network of Research in Substance Use Disorders (NOR-SUD), 4 Avenue de l'observatoire, Paris, 75006, France.
Florence VorspanDépartement de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, GHU APHP.Nord - Université Paris Cité, 200 Rue du Faubourg Saint-Denis, Paris, 75010, France.
Virgile Clergue-DuvalDépartement de Psychiatrie et de Médecine Addictologique, Site Lariboisière Fernand-Widal, GHU APHP.Nord - Université Paris Cité, 200 Rue du Faubourg Saint-Denis, Paris, 75010, France. virgile.clergue-duval@aphp.fr.ORCID http://orcid.org/0000-0003-2803-8249

Funding

Fédération Hospitalo-Universitaire Network of Research in Substance Use Disorders, Assistance Publique Hopitaux de Paris and Université Paris Cité, Paris, France Fédération Hospitalo-Universitaire Network of Research in Substance Use Disorders, Assistance Publique Hopitaux de Paris and Université Paris Cité, Paris, France
6 · The paper itself

Abstract

rationaleNo drugs are currently validated to treat psychostimulant use disorder (PUD). Pathophysiological studies consistently highlight the contribution of cholinergic mechanisms in psychostimulant use, including the vulnerability to PUD, paving the way for potential therapeutic strategies.

objectivesThe aim of this systematic review is to describe and discuss the efficacy of cholinergic agents in drug trials for patients with PUD.

methodsA systematic review was conducted on April 4, 2024 in MedLine, Embase and Cochrane Library databases on controlled clinical drug trial of cholinergic agents in humans with PUD, psychostimulant abuse or dependence and psychostimulant use in recent year.

resultsTwenty-eight articles were included, twenty-one on cocaine and seven on amphetamines. Cholinergic agents used in these studies were biperiden (a muscarinic antagonist), mecamylamine (a nicotinic antagonist), nicotinic agonists, acetylcholinesterase inhibitors (AChEI), or citicoline. Two types of trials were identified. There were seventeen randomized controlled clinical trials evaluating cholinergic agents on psychostimulant use reduction in outpatients seeking treatment. Additionally, we retrieved eleven short-term «proof-of-concept» laboratory trials mainly with supervised psychostimulant administration and/or triggered craving challenges. Outpatient trials were heterogeneous and for most, inconclusive. Only two studies on galantamine (AChEI) and citicoline, reported a significant reduction of cocaine consumption. «Proof-of-concept» laboratory trials showed no evidence of efficacy on the selected outcomes, notably on craving.

conclusionsThis review does not support the current prescription of cholinergic agents to treat PUD. Replication clinical trials notably on galantamine or other AChEI, and proof-of-concept trials on comedown symptoms will be necessary to identify a potential therapeutic indication for cholinergic agents in PUD.

Indexed as

Central Nervous System StimulantsCholinergic AgentsSubstance-Related DisordersAmphetamine-Related DisordersCocaine-Related DisordersHumansRandomized Controlled Trials as TopicTreatment OutcomeCentral Nervous System StimulantsCholinergic AgentsAcetylcholineAmphetaminesCholinergic agentsCocainePsychostimulantsPsychostimulant use disorder

Identifiers

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.