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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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2020
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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. |
format | Online Article Text |
id | pubmed-7302911 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
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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