Mirtazapine for Methamphetamine Use Disorder

Methamphetamine use disorder is associated with psychiatric and medical complications, including cardiovascular events, psychosis, and injury. Management relies largely on behavioral interventions, and no pharmacotherapies are approved for its treatment. Recently, mirtazapine has been proposed as a potential therapy given its serotonergic and adrenergic effects and ability to improve sleep and mood, but its effectiveness remains largely uncertain. In this double-blind randomized trial, 344 adults with moderate to severe methamphetamine use disorder (median use, 24 of the past 28 days) received mirtazapine (30 mg) or placebo for 12 weeks.