How are you thinking about incorporating mirtazapine into your treatment approach for patients with methamphetamine use disorder?

In my experience as an addiction psychiatrist in Maryland, I always found mirtazapine to be a low-hanging fruit in my "dual diagnosis" patients, re: reasonably quickly helping with insomnia and poor appetite that comes with drug use or especially opioid withdrawal. Also comes with the potential plus...

This answer was co-written by Professor Rebecca McKetin, BSc (Psychol) Hons, PhD.

Prescribing would be off-label, as there are no regulatory-approved medications for methamphetamine use. This would mean following local guidelines on off-label prescribing, reviewing evidence for mirtazapine (3 clinic...

Mirtazapine is a useful medication in treating methamphetamine use disorder, as has been demonstrated by Colfax et al., PMID 22065532 and Coffin et al., PMID 31825466, and now with further support from McKetin et al., PMID 41920558. It is generally well tolerated, has mood benefits as an antidepress...