เภสัชบำบัดสำหรับภาวะติดเมทแอมเฟตามีน: จากแนวทางดั้งเดิมสู่ความก้าวหน้าในปัจจุบัน

Charshawn Lahnwong; Anggoon Patarakorn

doi:10.64960/srimedj.v41i2.267786

Authors

Charshawn Lahnwong The Princess Mother National Institute on Drug Abuse Treatment, 60 Phahonyothin Road, Prachathipat Subdistrict, Thanyaburi District, Pathum Thani Province 12130
Anggoon Patarakorn The Princess Mother National Institute on Drug Abuse Treatment, 60 Phahonyothin Road, Prachathipat Subdistrict, Thanyaburi District, Pathum Thani Province 12130

DOI:

https://doi.org/10.64960/srimedj.v41i2.267786

Keywords:

methamphetamine use disorder, pharmacotherapy, combination pharmacotherapy, evidence-based medicine, innovative treatments

Abstract

Background and objectives: Methamphetamine use disorder currently lacks officially approved pharmacotherapy. This study aimed to review evidence-based pharmacotherapy using evolutionary synthesis to analyze the transition from conventional approaches to contemporary advances and novel mechanistic innovations during 2020–2026.

Methods: A systematic literature review was conducted via PubMed, Scopus, and Cochrane Library. Forty-four documents were selected, comprising systematic reviews, meta-analyses, and randomized controlled trials. The evidence was categorized into three phases: conventional pharmacotherapy, contemporary advances, and future innovations.

Results: Evidence supports the efficacy of injectable naltrexone combined with oral bupropion, which increased the response rate to 13.6% compared to 2.5% in the placebo group (p < 0.001). Oral mirtazapine also demonstrated a significant reduction in substance use (p = 0.004), whereas most other drug classes showed limitations in achieving sustained abstinence. Future directions focus on the development of immunotherapy and novel technologies with increased specificity toward brain mechanisms.

Conclusion: Injectable naltrexone combined with oral bupropion and oral mirtazapine are the most viable options currently available. However, achieving maximum treatment efficacy may require the systematic integration of pharmacotherapy and psychosocial interventions to enhance treatment retention and sustainable clinical outcomes.

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