Management of Methamphetamine Withdrawal

Clinical Presentation and Management

• The American College of Physicians recommends supportive care with symptom-targeted medications for methamphetamine withdrawal, as no specific pharmacological treatment has demonstrated efficacy in high-quality studies 1
• Agitation is a common symptom of methamphetamine withdrawal, and can be managed with supportive care and symptom-targeted medications 1
• Withdrawal is best undertaken in a supportive environment with close monitoring, and no specific medication is universally recommended for methamphetamine withdrawal treatment 1
• Relief of symptoms should be achieved with targeted symptomatic medications during the withdrawal period, and benzodiazepines may be used for short-term management of agitation and sleep disturbance 1
• Close monitoring is essential for individuals experiencing depression or anxiety during withdrawal, and consideration should be given to consultation with psychiatric specialists if symptoms are severe 1
• Depression and psychosis can occur during withdrawal and require specialized care, and vital signs should be monitored closely 1
• Short-duration psychosocial support based on motivational principles should be offered to individuals undergoing methamphetamine withdrawal, and those who do not respond to brief interventions should be referred for specialist assessment 1
• Consider referral to mutual help groups when appropriate, and for patients with severe, treatment-resistant symptoms, specialized addiction consultation is recommended 2
• Dexamphetamine should not be offered for the treatment of stimulant use disorders, and abrupt discontinuation of any co-prescribed benzodiazepines should be avoided to prevent severe withdrawal symptoms including seizures 1, 2
• Assessment for co-occurring mental health conditions that may complicate withdrawal management should not be overlooked 2