The Effects of Quetiapine on Craving and Withdrawal Symptoms in Methamphetamine Abuse: A Randomized, Double-Blind, Placebo-Controlled Trial

Background: Patients with Methamphetamine Abuse (MA) are susceptible to many complications like craving, and withdrawal symptoms. These trials were designed to evaluate the effect of quetiapine administration on craving and withdrawal symptoms in MA abuse. Methods: This trial was conducted on 60 people with MA abuse to receive either 100 mg quetiapine (n=30), or placebo (n=30) every day for 2 months. The Desire for Drug Questionnaire (DDQ) and Amphetamine Withdrawal Questionnaire (AWQ) scores were evaluated at baseline and after 2 months’ intervention. For data analysis, t test, and the Chi-square test were applied in SPSS v. 18. Results: Quetiapine significantly decreased DDQ (P=0.002) and AWQ symptoms (P=0.001) compared to the placebo. Furthermore, there was a significant difference among groups in terms of the frequency of negative urine tests (P<0.001). Conclusion: This trial showed that administration of quetiapine supplements for 2 months in individuals with MA abuse had beneficial effects on craving and withdrawal syndrome.

Psychometric Properties of Persian Version of the Amphetamine Withdrawal Questionnaire Version 2 (AWQV2) in Patients with Methamphetamine-Type Substance Use Disorder

Background: No standard self-report instrument for withdrawal symptoms is available in Iran. Objectives: This study aimed to evaluate the psychometric properties of the Persian version of the 10-item Amphetamine Withdrawal questionnaire version 2 (AWQV2). Methods: A sample of 388 methamphetamine addicts (215 females and 173 males) referred to addiction recovery centers and psychiatric ward of Farabi Hospital in Kermanshah. A two-stage random sampling method was used. The reliability and internal consistency of the AWQV2 items were examined using Cronbach’s alpha and test-retest reliability, respectively, and the instrument validity of the AWQV2 was measured using construct validity and convergent validity. Results: The AWQV2 had a Cronbach’s alpha of 0.72. Factor analysis using the main component analysis with a varimax rotation introduced three factors of hyperarousal, anxiety, and reversed vegetative symptoms. These factors explained 0.58 of the total variance. The coefficient of test-retest reliability at a 2-week interval was equal to 0.77. The convergent validity of the AWQV2 was examined by simultaneously administering the Advanced Warning of Relapse (AWARE) questionnaire to 40 subjects, with a correlation coefficient of 0.81. Conclusions: Based on the results, the AWQV2 has very good psychometric properties and may be used in research and therapeutic interventions.

Amphetamine Withdrawal Differentially Increases the Expression of Organic Cation Transporter 3 and Serotonin Transporter in Limbic Brain Regions

Amphetamine withdrawal increases anxiety and stress sensitivity related to blunted ventral hippocampus (vHipp) and enhances the central nucleus of the amygdala (CeA) serotonin responses. Extracellular serotonin levels are regulated by the serotonin transporter (SERT) and organic cation transporter 3 (OCT3), and vHipp OCT3 expression is enhanced during 24 hours of amphetamine withdrawal, while SERT expression is unaltered. Here, we tested whether OCT3 and SERT expression in the CeA is also affected during acute withdrawal to explain opposing regional alterations in limbic serotonergic neurotransmission and if respective changes continued with two weeks of withdrawal. We also determined whether changes in transporter expression were confined to these regions. Male rats received amphetamine or saline for two weeks followed by 24 hours or two weeks of withdrawal, with transporter expression measured using Western immunoblot. OCT3 and SERT expression increased in the CeA at both withdrawal timepoints. In the vHipp, OCT3 expression increased only at 24 hours of withdrawal, with an equivalent pattern seen in the dorsomedial hypothalamus. No changes were evident in any other regions sampled. These regionally specific changes in limbic OCT3 and SERT expression may partially contribute to the serotonergic imbalance and negative affect during amphetamine withdrawal.