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No established medications increase abstinence rates from amphetamine-type stimulant use disorder (ATS-UD), either with or without the common comorbidity of opioid use disorder (OUD). However, animal and human laboratory studies have suggested the utility of atomoxetine for treating ATS-UD. This norepinephrine transporter inhibitor, which is approved for treating attention-deficit/hyperactivity disorder (ADHD), increases synaptic norepinephrine levels throughout the brain, raises dopamine levels in the prefrontal cortex, and has little abuse potential.
In a double-blind pilot trial in Malaysia, 69 men with OUD and ATS-UD were admitted to a residential treatment program for 10 days, stabilized on buprenorphine/naloxone, and, after 5 to 7 days…