Gender Differences in Bupropion Response in Methamphetamine ...

Martha Bethzabé Hinojosa, Ph.D., FNP-BC,RNPost-doctoral AssociateBaylor College of MedicineMenninger Department of PsychiatryHouston, TX2011 International NHSN Conference1

Background IIGender DifferencesCLINICAL STUDIESHawkins, et al., 2010• Meth and cocaine users• Females display more psychosis than males• Paranoid & grandiose delusions, bodydimorphism, auditory, olfactory & tactilehallucinations3

Research QuestionDo subjective responses differ bygender to bupropion innon-treatment seekingmethamphetamine users?4

Methods• Double-blind, placebo controlled study• Methamphetamine users• IV methamphetamine (0, 15, 30 mg)• Twice daily dosing of placebo or bupropion(150 mg, bid)participants meth + bupropionmeth + placebo5

MeasurementsVisual Analogue Scale (VAS)• Measures craving, euphoria and dysphoria• Includes: ‘Any drug effect’, ‘High’, ‘Good’,‘Bad effects’, ‘Like’, ‘Depressed’, ‘Anxious’ &‘Access’• Physiological: HR, BP• BDI: Beck Depression Inventory6

Visual Analogue Scale7

EthnicityDemographic and Drug Use CharacteristicsWhiteHispanicOtherFemales(n=9)Males(n=9)6 33 40 2Age 33.4 3.9 33.7 1.4Education 14.1 0.4* 13.1 0.6BDI 8.3 2.8* 4.9 2.2Years of MA use 15.6 3.4 14.8 1.0MA use in last 30 days 17.3 3.2 16.2 1.88

60Males and Females Respond Similarly to MethFemalesMales605050VAS Scores40302040302010100BaselineDesire forMethChangeDesireChangeAnyDrugChangeHighChange calculated as T=30 min - T=-15 minafter methamphetamine (30 mg, IV)09

Males and Females Respond Differently toBupropion Treatment10

DiscussionBoth genders respond similarly tomethamphetamine as measured via the VAShowever; when treated with bupropion,females:• Reported increased ratings (range 5-20 points)for ‘High’, and• Reported increased ratings for ‘Any drug effect’(data not shown)• Therefore, females did not respond tobupropion treatment.11

Future Directions• Substance Abuse programs formethamphetamine addiction may need toaddress gender differences for specificpharmacological treatments• Need to investigate other medication andbehavioral therapies to address these genderdifferences12

Baseline Differences in Methamphetamine UseBetween Males vs. Females10090MALES (N=122)FEMALES (N=66)*1009080807020MALESFEMALESp=0.12720706015p=0.0781560505040*105p=0.23810540303020100*BDIMeth(d/30)Meth(g/d)020100Age(y)Meth(y)BDIMeth(d/30)Meth(g/d)Meth($/d)013

Acknowledgements• Thomas Newton, M.D.• Richard De La Garza, II, Ph.D.• James Mahoney, III, M.A.• Supported by contracts from NIDA (DA08804,DA014593, RR00865)14

Contact InformationMartha B. Hinojosa, Ph.D., FNP-BC, RNPostdoctoral AssociateBaylor College of MedicineMenninger Department of PsychiatryHouston, TX(713) 791 1414 x4747marthah@bcm.edu15