Paracetamol in the Treatment of Acute Amphetamine Withdrawal
Article Sidebar
Main Article Content
Abstract
Objectives: To examine the benefits of paracetamol in treating acute amphetamine withdrawal.
Methods: Randomized Controlled Trial, Experimental case-control study in patients diagnosed with Amphetamine Use Disorder ages 18-60 years at the outpatient and inpatient departments of Nakhon Sawan Rajanagarindra Psychiatric Hospital, from November 2021 to April 2022. 52 participants were randomized by Block of Four Randomization. The experimental group received 750 mg of paracetamol and the control group received a placebo. The outcome was measured by Amphetamine Withdrawal Symptom Questionnaire (AWQV2) and Visual Analogue Scale (VAS) (drug craving - VAS1) (relaxation - VAS2). Individual characteristics were analyzed by frequency, mean, percentage, and standard deviation. Chi-squre test and Fisher exact test were used to compare individual characteristics between groups. Variable changes were analyzed by the T-Test statistics.
Results: Hyperarousal Subscale Score from the AWQV2 test (combined scores of drug-craving, agitation, and vivid or unpleasant dreams items), and drug craving scores (VAS1) were significantly lower in the experimental group (P=0.012 and P=0.002, respectively). Drowsiness was observed in both the experimental group and control group, 2 per group, with mild severity.
Conclusions: Paracetamol was more effective than placebo in treating acute amphetamine withdrawal in the Hyperarousal Subscale Score and in reducing cravings. And no serious adverse reactions were found.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความหลังผ่านการปรับแก้จากกองบรรณาธิการแล้ว เป็นลิขสิทธ์ของวารสารจิตเวชวิทยาสาร โรงพยาบาลสวนปรุง กรมสุขภาพจิต กระทรวงสาธารณสุข ห้ามเผยแพร่เพื่อประโยชน์ทางการค้าโดยไม่ได้รับอนุญาต แต่อนุญาตให้เผยแพร่บทความดังกล่าวเพื่อประโยชน์ทางการศึกษาแก่ประชาชนทั่วไป ทั้งนี้กองบรรณาธิการไม่จำเป็นต้องเห็นด้วยกับบทความหรือข้อคิดเห็นใดๆ ที่ปรากฏในวารสารสวนปรุง
References
Kaplan HI, Sadock BJ, Ruitz P. Synopsis of psychiatry: behavioral sciences, clinical psychiatry. 11th ed. Baltimore: Wolters & Kluwer; 2015.
Sirisupakritkul N, Phanburananon B. Handbook of drug identification in preliminaries. Nonthaburi: Bureau of Drugs and Narcotics Department of Medical Sciences Ministry of Health; 2017. (in Thai)
Kanato M, Leyatikul P, Wonguppa R. Size estimation of substances users population in Thailand 2019. ONCB Journal 2020;36(2):37-48.
Grigg J, Manning V, Arunogiri S, Volpe I, Frei M, Phan V, et al. Methamphetamine treatment guidelines: practice guidelines for health professionals. 2nd ed. Victoria: Turning Point; 2018.
Lalitanantpong D. Methamphetamine, etiologies and treatments. Chula Med J 2003 Apr;47(4):265-75. (in Thai)
Likitsatien S, Srisurapanon M. Drug use in the treatment of amphetamine addiction. Chiang Mai: Academic Program for the Development of Substance Abuse Care Models in the Community; 2013. (in Thai)
Dogrul A, Seyrek M, Akgul EO, Cayci T, Kahraman S, Bolay H. Systemic paracetamol- induced analgesic and antihyperalgesic effects through activation of descending serotonergic pathways involving spinal 5-HT₇ receptors. Eur J Pharmacol. 2012 Feb 29;677(1-3):93-101. PMID: 22206817.
Durso GR, Luttrell A, Way BM. Over-the-counter relief from pains and pleasures alike: acetaminophen blunts evaluation sensitivity to both negative and positive stimuli. Psychol Sci. 2015 Jun;26(6):750-8. PMID: 25862546.
Manning V, Arunogiri S, Frei M, Ridley K, Mroz K, Campbell S, Lubman D. Alcohol and drug withdrawal guidelines [Internet]. 2018 [cited 2022 Apr 1]. Available from: http://s3-ap-southeast-2.amazonaws.com/turning-point-website-prod/drupal/inline-files/Alcohol-and-Drug-Withdrawal-Guidelines-2018.pdf
Srisurapanont M, Jarusuraisin N, Jittiwutikan J. Amphetamine withdrawal: II. A placebo-controlled, randomised, double-blind study of amineptine treatment. Aust N Z J Psychiatry. 1999 Feb;33(1):94-8. PMID: 10197891.
Srisurapanont M, Jarusuraisin N, Jittiwutikarn J. Amphetamine withdrawal: I. Reliability, validity and factor structure of a measure. Aust N Z J Psychiatry. 1999; Feb;33(1):89-93. PMID: 10197890.
Lee JW, Brown ES, Perantie DC, Bobadilla L. A comparison of single-item Visual Analog Scales with a multiitem Likert-type scale for assessment of cocaine craving in persons with bipolar disorder. Addict Disord Their Treat. 2002;1(4):140-2. doi: 10.1097/00132576-200211000-00005.
Ministry of Public Health. Department of Mental Health. Guidelines for surveillance of depression at the provincial level. 3rd rev. ed. Nonthaburi: Department of Mental Health; 2014. (in Thai)
Kongsuk T, Arunpongpaisal S, Janthong S, Prukkanone B, Sukhawaha S, Leejongpermpoon J. Criterion-related validity of the 9 questions depression rating scale revised for Thai Central Dialect. J Psychiatr Assoc Thailand 2018;63(4):321-34. (in Thai)
Arunpongpaisal S, Kongsuk T, Maneethorn N, Maneethorn B, Wannasawek K, Leejongpermpoon J, et al. Development and validity of two-question screening test for depressive disorders in Northeastern Thai community. Asian J Psychiatr. 2009 Dec;2(4):149-52. PMID: 23051095.
Bhagyashree A, Manikkoth S, Sequeira M, Nayak R, Rao SN. Central dopaminergic system plays a role in the analgesic action of paracetamol: preclinical evidence. Indian J Pharmacol. 2017 Jan-Feb;49(1):21-5. PMID: 28458418.