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Methamphetamine use and its associated harms have been increasing, and effective treatment is lacking. Because small studies have suggested that bupropion and naltrexone, used individually, might have some efficacy, researchers combined them in this randomized trial: Bupropion (450 mg daily) plus extended-release injectable naltrexone (380 mg every 3 weeks) were compared with placebo in 403 adults with moderate-to-severe methamphetamine use disorder. In stage 1, participants received naltrexone-bupropion or placebo. Then, after 6 weeks, nonresponders in the placebo group were randomized again to naltrexone plus bupropion or placebo for another 6 weeks in stage 2.
The primary outcome was defined as at least three negative urine tests for meth…