Metamfetamine altered

When metamfetamine and amfebutamone (bupropion) were co-administered to 26 subjects, 20 of whom completed the protocol, there was no evidence of additive cardiovascular effects [32], The subjects received metamfetamine 0,15, and 30 mg intravenously before and after randomization to bupropion 150 mg bd in a modified-release formulation or matched placebo. There was a non-significant trend for amfebutamone to reduce metamfetamine-associated increases in blood pressure and a significant reduction in the metamfetamine-associated increase in heart rate. Amfebutamone reduced the plasma clearance of metamfetamine and the appearance of amfetamine in the plasma. Metamfetamine did not alter the peak and trough concentrations of amfebutamone or its metabolites. These findings are relevant to the potential use of amfebutamone in ameliorating acute abstinence in metamfetamine users. However, the risk of seizures during amfebutamone treatment for metamfetamine abuse has not been estimated. 

Metamfetamine The results of a doubleblind study of potential interactions of intravenous metamfetamine (15 and 30 mg) with oral aripiprazole (15 mg) have been published [72 ]. The effects of aripiprazole on abstinence-related craving and cue-induced craving were also evaluated. Participants included non-treatment-seeking metamfetamine-dependent patients who took aripiprazole (n = 8) or placebo (n = 8) for 2 weeks. Aripiprazole had no effect on cue-induced metamfetamine craving, but was associated with increased craving independent of metamfetamine dose, euphoria, and amphetamine-like effects after metamfetamine. Aripiprazole reduced the increase in systolic blood pressure after metamfetamine, but it had no other effects on cardiovascular responses to metamfetamine. Aripiprazole did not alter the pharmacokinetics of metamfetamine. The adverse events tended to be equally distributed between the two groups, except for tremor (n = 4) and restlessness n = 3), which were more common in those who took aripiprazole. 

Treatment of metamfetamine dependence with vigabatrin has been suggested. Possible cardiovascular adverse effects induced by the co-administration of these substances and the possible interaction between vigabatrin and metamfetamine have been evaluated in a double-blind, placebo-controlled, parallel-group study in healthy volunteers [436. Vigabatrin did not alter metamfetamine or amfetamine plasma concentrations or toxicity. There were no serious adverse events and the total number of adverse effects was similar in the two groups. There were no significant differences in systolic or diastohc blood pressures or heart rate. 

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