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Management of Acute Withdrawal and Detoxification for Adults who Misuse Methamphetamine: A Review of the Clinical Evidence and Guidelines

Last updated: February 8, 2019
Project Number: RC1067-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical evidence regarding methods to manage acute detoxification or withdrawal for adults who misuse methamphetamine?
  2. What are the evidence-based guidelines regarding the management of acute detoxification or withdrawal for adults who misuse methamphetamine?

Key Message

Good quality evidence from one systematic review suggested that aripiprazole, haloperidol, and quetiapine may be effective for the management of methamphetamine-induced psychosis. Intravenous lorazepam and droperidol may be effective for the management of agitation associated with acute methamphetamine toxicity in the emergency department and isradipine may be effective for the treatment of methamphetamine-induced high blood pressure. The results of two randomized controlled trials suggested that pexacerfont and buprenorphine may be effective for managing methamphetamine craving during methamphetamine withdrawal. One evidence-based guideline recommends benzodiazepines should be considered as a first line treatment option for the management of severe agitation, aggressiveness, or psychosis stemming from methamphetamine intoxication.