Evidence map›Paper›PMID 41920558›Full record

Trial reportJAMA psychiatry2026

Mirtazapine for Methamphetamine Use Disorder: A Randomized Clinical Trial.

Rebecca McKetin, Steven Shoptaw, Lucy Saunders, Long Nguyen, Philip J Clare, Gregory J Dore, Alyna Turner, Olivia M Dean, Peter J Kelly, Shalini Arunogiri and 33 more

Erratum issuedAbstract readRandomized Controlled TrialClinical Trial, Phase IIIMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in JAMA psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Error in Visual Abstract.JAMA psychiatry · 2026
    Article
  2. The use ofFrontiers in cell and developmental biology · 2026
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

43 authors.

Rebecca McKetinNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
Steven ShoptawDepartment of Family Medicine, David Geffen School of Medicine, Los Angeles, California.
Lucy SaundersNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
Long NguyenBurnet Institute, Melbourne, Victoria, Australia.
Philip J ClareNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
Gregory J DoreKirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
Alyna TurnerThe Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia.
Olivia M DeanThe Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia.
Peter J KellySchool of Psychology, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia.
Shalini ArunogiriMonash Addiction Research Centre, Eastern Health Clinical School, Monash University, Melbourne, Victoria, Australia.
Juanita KoeijersNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
Tayla J DeganNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
Louisa DegenhardtNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
Michael FarrellNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
David Goodman-MezaKirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
Barbara SinclairDrug and Alcohol Service, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia.
David ReidDrug and Alcohol Service, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia.
Frank CordaroDrug and Alcohol Service, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia.
Harry HillThe Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia.
Robert LundinThe Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia.
Jeremy HayllarBiala, Metro North Health, Brisbane, Queensland, Australia.
Michael ChristmassNext Step Community Alcohol and Drug Service, Perth, Western Australia, Australia.
Willy LiawDrug and Alcohol Services of South Australia, Adelaide, South Australia, Australia.
Danica LiuDrug and Alcohol Services of South Australia, Adelaide, South Australia, Australia.
Amelia WoodsNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
Blaire BrewertonDrug and Alcohol Services of South Australia, Adelaide, South Australia, Australia.
Ellie HolyoakAlcohol, Tobacco and Other Drugs Service, Townsville, Queensland, Australia.
Brian Tid-Fung WuAlcohol, Tobacco and Other Drugs Service, Townsville, Queensland, Australia.
Hayley MaherAlcohol, Tobacco and Other Drugs Service, Townsville, Queensland, Australia.
Noni O'DeaNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
Joel KeyganNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
Ava KontogiannisSchool of Psychology, Faculty of Arts, Social Sciences and Humanities, University of Wollongong, Wollongong, New South Wales, Australia.
Lily PalmerNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
Caity MorrisonThe Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia.
Anna WrobelThe Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia.
Bec HylandNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
Gift KidenNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
Vanessa RomeoNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
Khine Wut Yee KyawNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
Marianne ByrneKirby Institute, University of New South Wales, Sydney, New South Wales, Australia.
Samantha Colledge-FrisbyNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
Emma ZahraNational Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
Michael BerkThe Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Victoria, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Importance: Methamphetamine use disorder is a global health challenge for which there are no approved pharmacotherapies. The safety and effectiveness of mirtazapine, a promising candidate for methamphetamine use disorder, has not been established in routine clinical practice. Objective: To determine the safety and effectiveness of mirtazapine as a pharmacotherapy for methamphetamine use disorder in routine clinical practice. Design, Setting, and Participants: This phase 3, parallel-group, double-blind, placebo-controlled randomized clinical trial was conducted between November 16, 2022, and May 1, 2025, at 6 outpatient alcohol and other drug clinics in Australia among adults with moderate to severe methamphetamine use disorder. Data analysis was conducted from May to September 2025. Intervention: Mirtazapine (30 mg daily for 12 weeks) or equivalent placebo. Main Outcomes and Measures: The primary end point was the change in days of methamphetamine use in the past 28 days from baseline to week 12. Secondary end points were depression, insomnia, HIV risk behavior, quality of life, and methamphetamine-negative oral fluid samples. Results: Of 344 participants randomized, 339 participants received the intervention (167 in the placebo group and 172 in the mirtazapine group). Mean (SD) age was 42.0 (8.6) years, 126 participants (37.2%) were female, and participants had used methamphetamine for a median (IQR) of 24 days (17-28) of the past 28 days at baseline. The mean reduction in days of methamphetamine use from baseline to week 12 was greater in the mirtazapine group (7.0 days of 28 days) than in the placebo group (4.8 days of 28 days; mean difference, 2.2 days; 95% CI, -4.2 to -0.2 days; P = .02). More participants in the mirtazapine group reported drowsiness (47% vs 33%) and weight gain (10% vs 3%). Forty participants (23%) discontinued mirtazapine due to adverse events compared to 25 participants (15%) in the placebo group. No significant effects of mirtazapine on secondary end points were found. Conclusions and Relevance: In this parallel-group randomized clinical trial, mirtazapine delivered in routine clinical practice reduced methamphetamine use in adults with methamphetamine use disorder. No unexpected safety concerns delivering mirtazapine in this setting were found; this finding has important clinical implications in the absence of any approved pharmacotherapies for methamphetamine use disorder. Trial Registration: anzctr.org.au Identifier: ACTRN12622000235707.

Indexed as

Amphetamine-Related DisordersMethamphetamineMirtazapineAdultAustraliaDouble-Blind MethodFemaleHumansMaleMiddle AgedQuality of LifeTreatment OutcomeMethamphetamineMirtazapine

Identifiers

PMID41920558
PMCPMC13044789

What OpenQuestion holds

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Registered trials

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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.