Aripiprazole for the treatment of methamphetamine dependence: a randomized, double-blind, placebo-controlled trial

Addiction. 2013 Apr;108(4):751-61. doi: 10.1111/add.12073. Epub 2013 Jan 3.


Aims: To test aripiprazole for efficacy in decreasing use in methamphetamine-dependent adults, compared to placebo.

Design: Participants were randomized to receive 12 weeks of aripiprazole or placebo, with a 3-month follow-up and a platform of weekly 30-minute substance abuse counseling.

Setting: The trial was conducted from January 2009 to March 2012 at the San Francisco Department of Public Health.

Participants: Ninety actively using, methamphetamine-dependent, sexually active adults were recruited from community venues.

Measurements: The primary outcome was regression estimated reductions in weekly methamphetamine-positive urines. Secondary outcomes were study medication adherence [by self-report and medication event monitoring systems (MEMS)], sexual risk behavior and abstinence from methamphetamine.

Findings: Participant mean age was 38.7 years, 87.8% were male, 50.0% white, 18.9% African American, and 16.7% Latino. Eighty-three per cent of follow-up visits and final visits were completed. By intent-to-treat, participants assigned to aripiprazole had similar reductions in methamphetamine-positive urines as participants assigned to placebo [risk ratio (RR) 0.88, 95% confidence interval (CI): 0.66-1.19, P = 0.41]. Urine positivity declined from 73% (33 of 45 participants) to 45% (18 of 40) in the placebo arm and from 77% (34 of 44) to 44% (20 of 35) in the aripiprazole arm. Adherence by MEMS and self-report was 42 and 74%, respectively, with no significant difference between arms (MEMS P = 0.31; self-report P = 0.17). Most sexual risk behaviors declined similarly among participants in both arms (all P > 0.05). There were no serious adverse events related to study drug, although participants randomized to aripiprazole reported more akathisia, fatigue and drowsiness (P < 0.05).

Conclusion: Compared with placebo, aripiprazole did not reduce methamphetamine use significantly among actively using, dependent adults.

Trial registration: NCT00497055.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Amphetamine-Related Disorders / rehabilitation*
  • Amphetamine-Related Disorders / urine
  • Aripiprazole
  • Combined Modality Therapy
  • Counseling
  • Dopamine Agonists / therapeutic use*
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Medication Adherence
  • Methamphetamine*
  • Piperazines / therapeutic use*
  • Quinolones / therapeutic use*
  • Substance Abuse Detection
  • Treatment Failure


  • Dopamine Agonists
  • Piperazines
  • Quinolones
  • Methamphetamine
  • Aripiprazole

Associated data