Evidence map›Paper›PMID 40580890›Full record

Trial reportDrug and alcohol dependence2025

Mirtazapine reduces hypothetical methamphetamine demand in humans.

Craig R Rush, Glenn-Milo Santos, Vanessa M McMahan, Annie Fraser, Jesse Clark, Xochitl Luna Marti, John E Walker, Steve Shoptaw, Phillip O Coffin

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Drug and alcohol dependence, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–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

4 citing papers in PubMed.

  1. Trial
  2. Article
  3. The use ofFrontiers in cell and developmental biology · 2026
    Review
  4. Article
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

9 authors.

Craig R RushDepartment of Behavioral Science, College of Medicine, University of Kentucky, Lexington, KY, United States; Center for HIV Identification, Prevention, and Treatment Services, University of California Los Angeles, Los Angeles, CA, United States.
Glenn-Milo SantosCenter on Substance Use and Health, San Francisco Department of Public Health, San Francisco CA, United States; Community Health Systems, School of Nursing, University of California San Francisco, San Francisco CA, United States; Center for HIV Identification, Prevention, and Treatment Services, University of California Los Angeles, Los Angeles, CA, United States.
Vanessa M McMahanCenter on Substance Use and Health, San Francisco Department of Public Health, San Francisco CA, United States; Center for HIV Identification, Prevention, and Treatment Services, University of California Los Angeles, Los Angeles, CA, United States.
Annie FraserCenter on Substance Use and Health, San Francisco Department of Public Health, San Francisco CA, United States; Center for HIV Identification, Prevention, and Treatment Services, University of California Los Angeles, Los Angeles, CA, United States.
Jesse ClarkCommunity Health Systems, School of Nursing, University of California San Francisco, San Francisco CA, United States; Center for HIV Identification, Prevention, and Treatment Services, University of California Los Angeles, Los Angeles, CA, United States.
Xochitl Luna MartiCenter on Substance Use and Health, San Francisco Department of Public Health, San Francisco CA, United States; Center for HIV Identification, Prevention, and Treatment Services, University of California Los Angeles, Los Angeles, CA, United States.
John E WalkerCenter on Substance Use and Health, San Francisco Department of Public Health, San Francisco CA, United States; Center for HIV Identification, Prevention, and Treatment Services, University of California Los Angeles, Los Angeles, CA, United States.
Steve ShoptawCenter for HIV Identification, Prevention, and Treatment Services, University of California Los Angeles, Los Angeles, CA, United States; Department of Family Medicine, University of California Los Angeles, Los Angeles, CA, United States.
Phillip O CoffinCenter on Substance Use and Health, San Francisco Department of Public Health, San Francisco CA, United States; Center for HIV Identification, Prevention, and Treatment Services, University of California Los Angeles, Los Angeles, CA, United States; Department of Medicine, University of California San Francisco, San Francisco CA, United States. Electronic address: phillip.coffin@sfdph.org.

Funding

Mirtazapine for methamphetamine use disorder: drug-drug interaction studyU01DA051080 · NIDA · PUBLIC HEALTH FOUNDATION ENTERPRISES · PI COFFIN, PHILLIP O · 2020 to 2021
$4.4M
Midcareer K24 Award for Mentoring and Patient-Oriented ResearchK24DA042720 · NIDA · SAN FRANCISCO DEPARTMENT OF PUBLIC HEALTH · PI PHILLIP O COFFIN · 2016 to 2026
$1.6M
NIDA NIH HHS K24 DA042720NIDA NIH HHS U01 DA051080
6 · The paper itself

Abstract

backgroundPrevious trials showed mirtazapine reduces methamphetamine use. The present study determined the influence of mirtazapine treatment on the acute effects of methamphetamine.

methodsWe conducted a placebo-controlled, crossover, double-blind trial to determine the pharmacodynamic effects of intravenous methamphetamine (0, 30mg) after 5 days of mirtazapine (0, 30mg/day) treatment. Healthy adults with moderate to severe methamphetamine use disorder who had a positive baseline urine test for methamphetamine were enrolled. The order of mirtazapine and placebo was randomly assigned, and participants received a methamphetamine infusion during each treatment condition. Acute effects of methamphetamine were assessed using a drug purchasing task, a subjective effect questionnaire, and cardiovascular indices.

resultsFifteen (15) participants (10 cisgender males, 4 cisgender females, 1 transgender female) enrolled in the trial. Intravenous methamphetamine produced prototypical stimulant-like effects (e.g., hypothetical drug demand; increased ratings of Like Effect, heart rate, blood pressure) when participants were treated with placebo. Mirtazapine significantly decreased methamphetamine demand. The subjective and cardiovascular effects of methamphetamine were similar during mirtazapine and placebo treatment. Mirtazapine and infusions of methamphetamine, alone and combined, were well tolerated.

conclusionsMirtazapine reduced hypothetical drug demand and was well tolerated with saline or methamphetamine infusions. Considering these favorable findings, along with those from previous clinical trials, mirtazapine should continue to be tested as a putative pharmacotherapy for methamphetamine use disorder.

Indexed as

Amphetamine-Related DisordersCentral Nervous System StimulantsMethamphetamineMianserinMirtazapineAdultBlood PressureCross-Over StudiesDouble-Blind MethodFemaleHeart RateHumansMaleYoung AdultCentral Nervous System StimulantsMethamphetamineMianserinMirtazapineCardiovascular effectsHypothetical drug demandMethamphetamineMirtazapineSubjective effects

Identifiers

PMID40580890
PMCPMC12279006

What OpenQuestion holds

Textmetadata
LicenceTDM
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.