1- What are my Pharmacological options? Stimulant problems
With stimulants such as methamphetamine and cocaine, there aren’t any good medications for the treatment.
As mentioned in another video Addiction Treatment typically means a 3-4 prong approach.
The Prongs are
– Mutual Group/12-step program (Such as AA or Smart Recovery)
– Counselling “Treatment”- Residential/PHP/IOP/Aftercare +/- sober living
– Medical Management
– +/- Treat other conditions directly related to addiction rate (chiefly pain and psych issues)
The 4-prong approach becomes a 3-prong approach (and the 3-prong approach becomes a 2-prong approach) since there are no medicines that are FDA approved. (i.e. Get rid of prong “3” above). There are some medicines that may have some benefits but the evidence is weak so you may not find prescribers prescribing them. For instance, there are some antidepressants such as semiprime or bupropion, and some Parkinson’s medications such as amantadine that maybe help. But once, again, no good evidence. Furthermore, there was an African shrub. Ibogaine helped with stimulant disorders, however, it appeared to cause irregular heartbeat and sudden death so clinicians don’t prescribe it.
What are my Pharmacological options? (Benzos Problems)
Similar to stimulants, Benzodiazepines such as Xanax or Ativan don’t have that good of medications. They have medications for withdrawal which can be dangerous and lethal, and they have medications for acute intoxication with overdose, but when it comes to addiction itself there isn’t much that is beneficial. One medication that may provide benefit, and I use is topiramate (it calms down the brain). After quitting Benzo, a benzo user will feel uneasy/anxious for 1-6 months because glutamate in the brain is overactive. Topiramate is thought to decrease this glutamate. Similar to stimulants, treatment will focus on counseling, AA, and treating other comorbid conditions.