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Treatment of stimulant use disorder: A systematic review of reviews

AIMS: Stimulant use disorder contributes to a substantial worldwide burden of disease, although evidence-based treatment options are limited. This systematic review of reviews aims to: (i) synthesize the available evidence on both psychosocial and pharmacological interventions for the treatment of s...

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Autores principales: Ronsley, Claire, Nolan, Seonaid, Knight, Rod, Hayashi, Kanna, Klimas, Jano, Walley, Alex, Wood, Evan, Fairbairn, Nadia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302911/
https://www.ncbi.nlm.nih.gov/pubmed/32555667
http://dx.doi.org/10.1371/journal.pone.0234809
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author Ronsley, Claire
Nolan, Seonaid
Knight, Rod
Hayashi, Kanna
Klimas, Jano
Walley, Alex
Wood, Evan
Fairbairn, Nadia
author_facet Ronsley, Claire
Nolan, Seonaid
Knight, Rod
Hayashi, Kanna
Klimas, Jano
Walley, Alex
Wood, Evan
Fairbairn, Nadia
author_sort Ronsley, Claire
collection PubMed
description AIMS: Stimulant use disorder contributes to a substantial worldwide burden of disease, although evidence-based treatment options are limited. This systematic review of reviews aims to: (i) synthesize the available evidence on both psychosocial and pharmacological interventions for the treatment of stimulant use disorder; (ii) identify the most effective therapies to guide clinical practice, and (iii) highlight gaps for future study. METHODS: A systematic database search was conducted to identify systematic reviews and meta-analyses. Eligible studies were those that followed standard systematic review methodology and assessed randomized controlled trials focused on the efficacy of interventions for stimulant use disorder. Articles were critically appraised using an assessment tool adapted from Palmeteer et al. and categorized for quality as ‘core’ or ‘supplementary’ reviews. Evidence from the included reviews were further synthesized according to pharmacological or non-pharmacological management themes. RESULTS: Of 476 identified records, 29 systematic reviews examining eleven intervention modalities were included. The interventions identified include: contingency management, cognitive behavioural therapy, acupuncture, antidepressants, dopamine agonists, antipsychotics, anticonvulsants, disulfiram, opioid agonists, N-Acetylcysteine, and psychostimulants. There was sufficient evidence to support the efficacy of contingency management programs for treatment of stimulant use disorder. Psychostimulants, n-acetylcysteine, opioid agonist therapy, disulfiram and antidepressant pharmacological interventions were found to have insufficient evidence to support or discount their use. Results of this review do not support the use of all other treatment options. CONCLUSIONS: The results of this review supports the use of contingency management interventions for the treatment of stimulant use disorder. Although evidence to date is insufficient to support the clinical use of psychostimulants, our results demonstrate potential for future research in this area. Given the urgent need for effective pharmacological treatments for stimulant use disorder, high-quality primary research focused on the role of psychostimulant medications for the treatment of stimulant use disorder is needed.
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spelling pubmed-73029112020-06-19 Treatment of stimulant use disorder: A systematic review of reviews Ronsley, Claire Nolan, Seonaid Knight, Rod Hayashi, Kanna Klimas, Jano Walley, Alex Wood, Evan Fairbairn, Nadia PLoS One Research Article AIMS: Stimulant use disorder contributes to a substantial worldwide burden of disease, although evidence-based treatment options are limited. This systematic review of reviews aims to: (i) synthesize the available evidence on both psychosocial and pharmacological interventions for the treatment of stimulant use disorder; (ii) identify the most effective therapies to guide clinical practice, and (iii) highlight gaps for future study. METHODS: A systematic database search was conducted to identify systematic reviews and meta-analyses. Eligible studies were those that followed standard systematic review methodology and assessed randomized controlled trials focused on the efficacy of interventions for stimulant use disorder. Articles were critically appraised using an assessment tool adapted from Palmeteer et al. and categorized for quality as ‘core’ or ‘supplementary’ reviews. Evidence from the included reviews were further synthesized according to pharmacological or non-pharmacological management themes. RESULTS: Of 476 identified records, 29 systematic reviews examining eleven intervention modalities were included. The interventions identified include: contingency management, cognitive behavioural therapy, acupuncture, antidepressants, dopamine agonists, antipsychotics, anticonvulsants, disulfiram, opioid agonists, N-Acetylcysteine, and psychostimulants. There was sufficient evidence to support the efficacy of contingency management programs for treatment of stimulant use disorder. Psychostimulants, n-acetylcysteine, opioid agonist therapy, disulfiram and antidepressant pharmacological interventions were found to have insufficient evidence to support or discount their use. Results of this review do not support the use of all other treatment options. CONCLUSIONS: The results of this review supports the use of contingency management interventions for the treatment of stimulant use disorder. Although evidence to date is insufficient to support the clinical use of psychostimulants, our results demonstrate potential for future research in this area. Given the urgent need for effective pharmacological treatments for stimulant use disorder, high-quality primary research focused on the role of psychostimulant medications for the treatment of stimulant use disorder is needed. Public Library of Science 2020-06-18 /pmc/articles/PMC7302911/ /pubmed/32555667 http://dx.doi.org/10.1371/journal.pone.0234809 Text en © 2020 Ronsley et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Ronsley, Claire
Nolan, Seonaid
Knight, Rod
Hayashi, Kanna
Klimas, Jano
Walley, Alex
Wood, Evan
Fairbairn, Nadia
Treatment of stimulant use disorder: A systematic review of reviews
title Treatment of stimulant use disorder: A systematic review of reviews
title_full Treatment of stimulant use disorder: A systematic review of reviews
title_fullStr Treatment of stimulant use disorder: A systematic review of reviews
title_full_unstemmed Treatment of stimulant use disorder: A systematic review of reviews
title_short Treatment of stimulant use disorder: A systematic review of reviews
title_sort treatment of stimulant use disorder: a systematic review of reviews
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7302911/
https://www.ncbi.nlm.nih.gov/pubmed/32555667
http://dx.doi.org/10.1371/journal.pone.0234809
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