***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: AIM Modafinil was tested for efficacy in decreasing use in methamphetamine-dependent participants , compared to placebo . METHODS This was a r and omized , double-blind , placebo-controlled study , with 12 weeks of treatment and a 4-week follow-up . Eight outpatient substance abuse treatment clinics participated in the study . There were 210 treatment-seekers r and omized , who all had a DSM-IV diagnosis of methamphetamine dependence ; 68 participants to placebo  , 72 to modafinil  200 mg , and 70 to modafinil 400 mg , taken once daily on awakening . Participants came to the clinic three times per week for assessment s , urine drug screens , and group psychotherapy . The primary outcome measure was a methamphetamine non-use week , which required all the week 's qualitative urine drug screens to be negative for methamphetamine . RESULTS Regression analysis showed no significant difference between either modafinil group ( 200 or 400 mg ) or placebo in change in weekly percentage having a methamphetamine non-use week over the 12-week treatment period ( p=0.53 ) . Similarly , a number of secondary outcomes did not show significant effects of modafinil . However , an ad-hoc analysis of medication compliance , by urinalysis for modafinil and its metabolite , did find a significant difference in maximum duration of abstinence ( 23 days vs. 10 days , p=0.003 ) , between those having the top quartile of compliance ( > 85 % of urines were positive for modafinil , N=36 ) , and the lower three quartiles of modafinil 200 and 400 mg groups ( N=106 ) . CONCLUSIONS Although these data suggest that modafinil , plus group behavioral therapy , was not effective for decreasing methamphetamine use , the study is probably inconclusive because of inadequate compliance with taking medication The safety and tolerability of modafinil  ( 400 mg/day , n = 14 ) and  mirtazapine  ( 60 mg/day , n = 13 ) in inpatient methamphetamine withdrawal treatment were compared to a historical comparison group receiving treatment as usual ( pericyazine , 2.5 - 10 mg/day , n = 22 ) . Modafinil and mirtazapine were well tolerated , producing minimal positive subjective effects and no discontinuation effects in this open-label study . Side effects were mild and transient . Aches and pains were most commonly reported by participants receiving mirtazapine , whereas headache was reported by modafinil-treated participants . Modafinil-treated participants had a milder withdrawal syndrome as measured by the Amphetamine Cessation Symptom Assessment and less sleep disturbance in comparison to mirtazapine . Pericyazine was associated with a more severe withdrawal syndrome in comparison to mirtazapine and modafinil . Both modafinil and mirtazapine were safe and well tolerated in methamphetamine withdrawal treatment . However , these early findings of efficacy in symptom amelioration should be replicated in an adequately powered , r and omized , placebo-controlled double-blind design AIM To investigate the safety and efficacy of once-daily supervised oral administration of sustained-release dexamphetamine in people dependent on methamphetamine . DESIGN R and omized , double-blind , placebo-controlled trial . PARTICIPANTS Forty-nine methamphetamine-dependent drug users from Drug and Alcohol Services South Australia ( DASSA ) clinics . INTERVENTION Participants were assigned r and omly to receive up to 110 mg/day sustained-release dexamphetamine ( n = 23 ) or placebo ( n = 26 ) for a maximum of 12 weeks , with gradual reduction of the study medication over an additional 4 weeks . Medication was taken daily under pharmacist supervision . MEASUREMENTS Primary outcome measures included treatment retention , measures of methamphetamine consumption ( self-report and hair analysis ) , degree of methamphetamine dependence and severity of methamphetamine withdrawal . Hair sample s were analysed for methamphetamine using liquid chromatography-mass spectrometry . FINDINGS Treatment retention was significantly different between groups , with those who received dexamphetamine remaining in treatment for an average of 86.3 days compared with 48.6 days for those receiving placebo ( P = 0.014 ) . There were significant reductions in self-reported methamphetamine use between baseline and follow-up within each group ( P < 0.0001 ) , with a trend to a greater reduction among the dexamphetamine group ( P = 0.086 ) . Based on hair analysis , there was a significant decrease in methamphetamine concentration for both groups ( P < 0.0001 ) . At follow-up , degree of methamphetamine dependence was significantly lower in the dexamphetamine group ( P = 0.042 ) . Dexamphetamine maintenance was not associated with serious adverse events . CONCLUSIONS The results of this preliminary study have demonstrated that a maintenance pharmacotherapy programme of daily sustained-release amphetamine dispensing under pharmacist supervision is both feasible and safe . The increased retention in the dexamphetamine group , together with the general decreases in methamphetamine use , degree of dependence and withdrawal symptom severity , provide preliminary evidence that this may be an efficacious treatment option for methamphetamine dependence OBJECTIVE To compare bupropion to placebo for reducing  methamphetamine ( MA ) use , increasing retention , and reducing the severity of depressive symptoms and MA-cravings . A secondary objective compared bupropion to placebo for reducing cigarette smoking among MA dependent participants . METHODS Following a 2-week , non-medication baseline screening period , 73 treatment-seeking MA dependent participants were r and omly assigned to bupropion sustained release ( 150 mg twice daily ; N=36 ) or placebo ( twice daily ; N=37 ) for 12-weeks under double-blind conditions . Participants attended clinic thrice weekly to provide urine sample s analyzed for MA-metabolite , to complete research measures and assessment s , and to receive contingency management and weekly cognitive behavioral therapy sessions . RESULTS There were no statistically significant effects for bupropion relative to placebo on MA use verified by urine drug screens , for reducing the severity of depressive symptoms or MA-cravings , or on study retention . In a post hoc analysis , there was a statistically significant effect of bupropion treatment on MA use among participants with lighter ( 0 - 2 MA-positive urines ) , but not heavier ( 3 - 6 MA-positive urines ) MA use during baseline ( OR=2.81 , 95 % CI=1.61 - 4.93 , p<0.001 for MA-free week with bupropion among light users ) . Bupropion treatment was also associated with significantly reduced cigarette smoking , by almost five cigarettes per day ( p=0.0002 ) . CONCLUSION Bupropion was no more effective than placebo in reducing MA use in planned analyses , though bupropion did reduce cigarette smoking . Post hoc findings of an effect for bupropion among baseline light , but not heavy , MA users suggests further evaluation of bupropion for light-MA users is warranted The efficacy of stimulant treatment in patients with substance use disorders and comorbid attention deficit hyperactivity disorder ( ADHD ) has been tested for cocaine and alcohol dependence but so far no studies have been conducted in amphetamine dependent individuals . The present trial was a pilot study aim ing to test the feasibility of treating amphetamine dependent patients with comorbid ADHD with central stimulant medication . The study was a double-blind , placebo controlled trial with parallel groups design comparing the efficacy of a fixed dose ( 72 mg ) of OROS methylpheni date ( MPH ) with placebo ( PL ) in reducing ADHD symptoms in currently abstinent adults with amphetamine dependence and ADHD . Twenty-four treatment seeking patients who met the DSM IV criteria for amphetamine dependence and ADHD were r and omized to MPH/PL . The trial was conducted at an outpatient facility with twice weekly visits , measuring ADHD symptoms and drug use . Patients rated their ADHD symptoms on a weekly basis and provided supervised urine specimens for drug toxicology twice weekly . All patients participated in weekly sessions of a skills training programme . Both the groups significantly reduced their self-rated ADHD symptoms during the 12-week treatment but there was no difference between the two treatment arms . Drug use , both measured by urine toxicology and self-report did not differ between the groups . No difference was found between the two groups with regards to craving for amphetamine or in retention in treatment . Larger studies with higher doses combined with individual dosage and longer follow-up periods are warranted Methamphetamine is a highly addictive stimulant and long-term exposure leads to reductions in dopamine . One therapeutic strategy is to develop and test compounds that normalize dopamine . The primary aim of this study was to determine the safety of modafinil treatment during methamphetamine exposure in a controlled clinical setting .  Methamphetamine-dependent volunteers ( N=13 ) , who were not seeking treatment , were r and omized to receive either modafinil ( 200 mg , PO ) or matching placebo over three days ( Days 1 - 3 or Days 8 - 10 ) . On Day 1 , subjects were r and omized to modafinil or placebo in the morning , and then 3 and 6h later received infusions of methamphetamine ( 0 and 30 mg , i.v . ) , after which cardiovascular and subjective effects were assessed . On Day 3 , participants completed i.v . self-administration sessions during which they made 10 choices for low doses of methamphetamine ( 3 mg , i.v . ) or saline . Days 4 - 7 were used as a washout period . On Day 8 participants were assigned to the alternate study medication ( placebo or modafinil ) , and the same testing procedures were repeated through Day 10 . The data reveal that modafinil treatment was well-tolerated and not associated with increased incidence of adverse events . In general , modafinil reduced by approximately 25 % ratings of methamphetamine-induced " Any Drug Effect " , " High " , and " Want Methamphetamine " , and reduced total number of choices for methamphetamine and monetary value of methamphetamine  , though none of these measures reached statistical significance . Given these encouraging , though non-significant trends , the primary conclusion is that it appears safe to proceed with modafinil in further clinical evaluations of therapeutic efficacy AIM To examine the safety and efficacy of modafinil ( 200 mg/day ) compared to placebo in the treatment of methamphetamine dependence and to examine predictors of post-treatment outcome . PARTICIPANTS AND DESIGN Eighty methamphetamine-dependent subjects in Sydney , Australia were allocated r and omly to modafinil ( 200 mg/day ) ( n = 38 ) or placebo ( n = 42 ) under double-blind conditions for 10 weeks with a further 12 weeks post-treatment follow-up . MEASURES Comprehensive drug use data ( urine specimens and self-report ) and other health and psychosocial data were collected weekly during treatment and research interviews at baseline , week 10 and week 22 . RESULTS Treatment retention and medication adherence were equivalent between groups . There were no differences in methamphetamine abstinence , craving or severity of dependence . Medication-compliant subjects tended to provide more methamphetamine-negative urine sample s over the 10-week treatment period ( P = 0.07 ) . Outcomes were better for methamphetamine-dependent subjects with no other substance dependence and those who accessed counselling . There were statistically significant reductions in systolic blood pressure ( P = 0.03 ) and weight gain ( P = 0.05 ) in modafinil-compliant subjects compared to placebo . There were no medication-related serious adverse events . Adverse events were generally mild and consistent with known pharmacological effects . CONCLUSIONS Modafinil demonstrated promise in reducing methamphetamine use in selected methamphetamine-dependent patients . The study findings support definitive trials of modafinil in larger multi-site trials OBJECTIVE Problems related to illegal amphetamine use have become a major public health issue in many developed countries . To date , evidence on the effectiveness of psychosocial treatments has remained modest , and no pharmacotherapy has proven effective for amphetamine dependence . METHOD Individuals meeting DSM-IV criteria for intravenous amphetamine dependence ( N=53 ) were r and omly assigned to receive aripiprazole ( 15 mg/day ) , slow-release methylpheni date ( 54 mg/day ) , or placebo for 20 weeks . The study was terminated prematurely due to unexpected results of interim analysis . An intention-to-treat analysis was used . The primary outcome measure was the proportion of amphetamine-positive urine sample s. RESULTS Patients allocated to aripiprazole had significantly more amphetamine-positive urine sample s than patients in the placebo group ( odds ratio= 
    Output:
    
No significant differences were found between psychostimulants and placebo for any of the studied efficacy outcomes .
Results of this review do not support the use of psychostimulant medications at the tested doses as a replacement therapy for amphetamine abuse or dependence .