Methamphetamine Use DisorderPhase 3ADAPT-2NCT03078075
Accelerated Development of Additive Pharmacotherapy Treatment (ADAPT-2) for Methamphetamine Use Disorder
A Phase 3 study testing Naltrexone: Vivitrol® and Bupropion: Wellbutrin XL® in people with Methamphetamine Use Disorder, run by University of Texas Southwestern Medical Center at 8 sites in United States.
Trial summary
This is a double-blind, placebo-controlled, randomized clinical trial evaluating the efficacy of extended-release naltrexone plus bupropion as a combination pharmacotherapy for methamphetamine use disorder. Read more about this study
- Who is it for?
- Ages 18 to 65 years
- Conditions the study is for
- Methamphetamine Use Disorder
- What is being tested?
- Naltrexone: Vivitrol® and Bupropion: Wellbutrin XL®
- Type of treatment
- Pill or oral medicine, Injection or infusion
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 403 participants
- Where
- 8 sitesUnited States
- Study dates
- 5 May 2017to 25 Jul 2019
- Phase
- Phase 3
- Are there results?
- Yes, posted in the registrySummary in the doctors' view
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 65 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- 18 to 65 years old;
- Interested in reducing/stopping methamphetamine use;
- Speak English;
- Agree to use acceptable birth control (if applicable);
- Be opioid-free at randomization;
- Willing to comply with all study procedures and medication instructions;
- Agree to use a cell phone (or similar study device) to take videos of medication dosing.
Who cannot join
- Medical or psychiatric condition which would make participation unsafe;
- Recently participated in a study of pharmacological or behavioral treatment for methamphetamine use disorder;
- Recently taken an investigational drug;
- Prescribed and taken naltrexone or bupropion ≤ 30 days from consent;
- Current or planned extended absence during study period (e.g., jail, surgery, pending legal action);
- Currently pregnant or breastfeeding.
Trial locations and contacts
8 sites in 1 country.
8 sites in 1 country
United States8 sites
University of Texas Southwestern Medical Center
Dallas, Texas, 75235
University of Texas Health Science Center - Center for Neurobehavioral Research on Addiction (CNRA)
Houston, Texas, 77054
University of California Los Angeles (UCLA) Center for Behavioral Addiction Medicine (CBAM)
Los Angeles, California, 90038
Hennepin County Medical Center- Berman Center for Research
Minneapolis, Minnesota, 55415
New York State Psychiatric Institute (NYSPI)- Substance Use Research Center (SURC)
New York, New York, 10032
Behavioral Health Services (BHS) of Pickens County
Pickens, South Carolina, 29671
CODA, Inc.
Portland, Oregon, 97214
Substance Use Research Unit (SURU) at the San Francisco Dept. of Public Health
San Francisco, California, 94102
About this study
Official title: NIDA (National Institute on Drug Abuse) CTN (Clinical Trials Network) Protocol 0068: Accelerated Development of Additive Pharmacotherapy Treatment (ADAPT-2) for Methamphetamine Use Disorder
This is a double-blind, placebo-controlled, randomized clinical trial evaluating the efficacy of extended-release naltrexone plus bupropion as a combination pharmacotherapy for methamphetamine use disorder. Participants will be randomly assigned to the active medication combination (AMC) group or matching placebo group and will receive medications over the course of 12 weeks. Follow-ups will occur in weeks 13 and 16.
Read the detailed description
There will be 400 adults with moderate or severe methamphetamine use disorder randomized into this multi-site study. Eligibility will be determined during a maximum 21 day screening period. After screening is completed and eligibility is confirmed, including successful administration of a naloxone challenge, participants will begin the 12 week medication phase of the trial. Participants will be randomized to either the 1) AMC arm and receive injections of extended release naltrexone (XR-NTX; as Vivitrol®) plus once-daily oral extended-release bupropion tablets (BUP-XL) or the 2) matching placebo (PLB) arm and receive injections of placebo (iPLB) plus once-daily oral placebo (oPLB) tablets. During the course of the study, participants may be switched to another arm, as determined by the a priori adaptive aspect of the study design. Participants appearing to respond well to their original treatment assignment will not be switched. Overall, approximately 50% of the participants will receive the AMC. Injections will be administered every three weeks, in weeks 1, 4, 7, and 10. Take-home oral study medication (BUP-XL or oPLB) will be dispensed weekly for dosing on non-clinic days. Participants will be asked to attend the clinic twice weekly for observed oral medication dosing, assessments, collection of urine samples, and once-weekly medical management. On non-clinic days, participants will participate in smartphone app-based medication adherence activities. Participants will be asked to complete assessments as indicated on the schedule of assessments. Following the 12 week medication phase, participants will complete a follow-up phase, including a medication taper and post-medication phase follow-up visits during weeks 13 and 16.
- Conditions
- Methamphetamine Use Disorder
- Being tested
- Naltrexone: Vivitrol®, Placebo (PLB) Injectable, Bupropion: Wellbutrin XL®, Placebo (PLB) Oral
- Keywords
- Methamphetamine, Methamphetamine Use Disorder, Naltrexone, Bupropion, Vivitrol®
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Naltrexone: Vivitrol®Drug
Also called Arm: Experimental - Active Medication Combination (AMC)
Naltrexone: 380 mg vial, 4 intramuscular injections administered every 3 weeks
Placebo (PLB) InjectableDrug
Also called Injectable matching (to Naltrexone) placebo, Arm: Placebo Comparator - matched Placebo (PLB)
Placebo: 4 intramuscular injections administered every 3 weeks
Bupropion: Wellbutrin XL®Drug
Also called Arm: Experimental - Active Medication Combination (AMC)
Bupropion: 450 mg oral dose daily
Placebo (PLB) OralDrug
Also called Oral matching (to Bupropion) placebo tablets, Arm: Placebo Comparator - matched Placebo (PLB)
Placebo: once-daily oral placebo tablets
| Study group | Role | What they receive |
|---|---|---|
| Active Medication Combination (AMC) | Experimental | injectable extended release naltrexone plus once daily oral extended-release bupropion tablets Receives: Drug: Naltrexone: Vivitrol®; Drug: Bupropion: Wellbutrin XL® |
| Matched Placebo (PLB) | Placebo comparator | injectable matching placebo plus once-daily oral placebo tablets Receives: Drug: Placebo (PLB) Injectable; Drug: Placebo (PLB) Oral |
What is being measured
The primary outcome is the main question the study is designed to answer.
Number of Participants With Treatment Response During Medication Phase at Stage 1
Treatment response is defined as 'Responder' and 'Non-Responder'. Responder : Participant who meets responder criterion by providing at least 3 out of a possible 4 methamphetamine-negative urine tests at the end of stage 1 (weeks 5-6).
Non-Responder: All other participants without 3 or 4 methamphetamine-negative urine drug test.
Measured: At week 6
Number of Participants in Placebo Arm With Treatment Response During Medication Phase at Stage 2
Treatment response is defined as 'Responder' and 'Non-Responder'. Responder : Participant who meet responder criterion by providing at least 3 out of a possible 4 methamphetamine-negative urine drug screens (UDS) at the end of stage 2 (weeks 11-12).
Non-Responder: All other participants without 3 or 4 methamphetamine-negative UDS.
Measured: At week 12
Number of Participants With Treatment Response During Medication Phase at Stage 1 (by Race)
Treatment response is defined as 'Responder' and 'Non-Responder'. Responder : Participant who meet responder criterion by providing at least 3 out of a possible 4 methamphetamine-negative urine tests at the end of stage 1 (weeks 5-6).
Non-Responder: All other participants without 3 or 4 methamphetamine-negative UDS (Urine Drug Screen).
Race: Black, White, Other
Measured: At week 6
Number of Participants With Treatment Response During Medication Phase at Stage 1 (by Ethnicity)
Treatment response is defined as 'Responder' and 'Non-Responder'. Responder : Participant who meets responder criterion by providing at least 3 out of a possible 4 methamphetamine negative urine tests at the end of stage 1 (weeks 5-6).
Non-Responder: All other participants without 3 or 4 methamphetamine-negative UDS (Urine Drug Screen).
Ethnicity: Hispanic, Non-Hispanic/Other
Measured: At Week 6
Number of Participants With Treatment Response During Medication Phase at Stage 1 (by Sex)
Treatment response is defined as 'Responder' and 'Non-Responder'. Responder : Participant who meet responder criterion by providing at least 3 out of a possible 4 methamphetamine-negative urine tests at the end of stage 1 (weeks 5-6).
Non-Responder: All other participants without 3 or 4 methamphetamine-negative UDS (Urine Drug Screen).
Sex: Female, Male
Measured: At week 6
Number of Participants With Treatment Response During Medication Phase at Stage 2 (by Race)
Treatment response is defined as 'Responder' and 'Non-Responder'. Responder : Participant who meet responder criterion by providing at least 3 out of a possible 4 methamphetamine-negative urine tests at the end of stage 2 (weeks 11-12).
Non-Responder: All other participants without 3 or 4 methamphetamine-negative UDS (Urine Drug Screen).
Race: Black, White, Other
Measured: At week 12
Number of Participants With Treatment Response During Medication Phase at Stage 2 (by Ethnicity)
Treatment response is defined as 'Responder' and 'Non-Responder'. Responder : Participant who meets responder criterion by providing at least 3 out of a possible 4 methamphetamine negative urine tests at the end of stage 2 (weeks 11-12).
Non-Responder: All other participants without 3 or 4 methamphetamine-negative UDS (Urine Drug Screen).
Ethnicity: Hispanic, Non-Hispanic/Other
Measured: at Week 12
Number of Participants With Treatment Response During Medication Phase at Stage 2 (by Sex)
Treatment response is defined as 'Responder' and 'Non-Responder'. Responder : Participant who meet responder criterion by providing at least 3 out of a possible 4 methamphetamine-negative urine tests at the end of stage 2 (weeks 11-12).
Non-Responder: All other participants without 3 or 4 methamphetamine-negative UDS (Urine Drug Screen).
Sex: Female, Male
Measured: At week 12
Secondary outcomes (27)
Treatment Effectiveness Score of Participants at Stage 1
The Treatment Effectiveness Score (TES) as measured by UDS results, during the treatment period. The TES is the percentage of the expected urine drug screens that were negative for each drug. Twelve urine drug screens are expected within each stage.
Measured: At weeks 6
Treatment Effectiveness Score of Participants at Stage 2
The Treatment Effectiveness Score (TES) as measured by UDS results, during the treatment period. The TES is the percentage of the expected urine drug screens that were negative for each drug. Twelve urine drug screens are expected within each stage. The range of possible scores are 0-100 and higher score indicates better outcomes.
Measured: At week 12
Percentage of Participants Who Used Methamphetamine in the Pre-evaluation Period
Methamphetamine use, as measured by UDS (urine drug screen) in the pre-evaluation period (Weeks 1-4 for Stage 1 and Weeks 7-10 for Stage 2 )
Measured: Weeks 1-4 and Weeks 7-10
Mean Maximum Number of Consecutive Visits Negative UDS at Stage 1
Measured by maximum consecutive negative UDS: Count the number and range 0-12 and report the maximum number.
Measured: At week 6
Mean Maximum Number of Consecutive Visits Negative UDS at Stage 2
Measured by maximum consecutive negative UDS: Count the number and range 0-12 and report the maximum number.
Measured: At week 12
Mean Number of Study Weeks With Two Methamphetamine-negative UDS at Stage 1
Measured by the number of study weeks during the treatment period with two methamphetamine-negative UDS.
Measured: At week 6
Mean Number of Study Weeks With Two Methamphetamine-negative UDS at Stage 2
Measured by the number of study weeks during the treatment period with two methamphetamine-negative UDS.
Measured: At week12
Mean Change of Percentage of Methamphetamine Abstinent Days Measured by Self-report at Stage 1
Methamphetamine use selfreported on TLFB ( Timeline Followback) during the follow-up period.
The baseline measure is the percentage of abstinent days in the 30 days prior to randomization. The outcome is the change in percentage of abstinent days.
Measured: Baseline, week 6
Mean Change Percentage of Methamphetamine Abstinent Days Measured by Self-report at Stage 2
Methamphetamine use selfreported on TLFB ( Timeline Followback) during the follow-up period.
The baseline measure is the percentage of abstinent days in the 30 days prior to randomization. The outcome is the change in percentage of abstinent days.
Measured: week 7, week 12
Mean Change of Methamphetamine Craving at Stage 1
Severity of methamphetamine craving, as measured by Visual Analog Craving Scales (VAS), during the treatment period. VAS scores range from 0 (no craving) to 100 (most intense craving possible). The VAS is completed at screening, once a week during the treatment period, and at the follow-up visits.
Measured: Baseline, week 6
Mean Change of Methamphetamine Craving at Stage 2
Severity of methamphetamine craving, as measured by Visual Analog Craving Scales (VAS), during the treatment period. VAS scores range from 0 (no craving) to 100 (most intense craving possible). The VAS is completed at screening, once a week during the treatment period, and at the follow-up visits.
Measured: week 7, week 12
Mean Number of Abstinent Days of Participants Who Used Other Substance Measured by UDS at Stage 1
Other substance use including Amphetamine, Non-Methamphetamine Drug, Cocaine, Alcohol, Cigarettes, as measured by UDS, during the treatment period. Opioid use will also be assessed using the Opioid 2000 ng tests on the UDS.
Measured: At week 6
Mean Number of Abstinent Days of Participants Who Used Other Substance Measured by UDS at Stage 2
Other substance use including Amphetamine, Non-Methamphetamine Drug, Cocaine, Alcohol, Cigarettes, as measured by UDS, during the treatment period. Opioid use will also be assessed using the Opioid 2000 ng tests on the UDS.
Measured: at week 12
Mean Change of Proportion of Other Substance Abstinent Days Measured by Self-report at Stage 1
Proportion of abstinent days of other substance including Alcohol, Cigarettes and E- Cigarettes was measured by self-report on TLFB during the treatment period.
Measured: Baseline, week 6
Mean Change of Proportion of Other Substance Abstinent Days Measured by Self-report at Stage 2
Proportion of abstinent days of other substance including Alcohol, Cigarettes and E- Cigarettes was measured by self-report on TLFB during the treatment period.
Measured: week 7, week 12
Mean Change in Number of Other Substance Use by Self-report at Stage 1
Number of other substance (Alcohol and Cigarettes) use was measured by self-report recall on Timeline Followback (TLFB) during the treatment period.
Measured: Baseline, week 6
Mean Change in Number of Other Substance Use by Self-report at Stage 2
Number of other substance (Alcohol and Cigarettes) use was measured by self-report recall on Timeline Followback (TLFB) during the treatment period.
Measured: week 7, week 12
Change in Proportion of E-cigarettes Abstinent Days by Self-report at Stage 1
Proportion of abstinent days of E- Cigarettes was measured by self-report at stage 1.
Measured: Baseline, week 6
Change in Proportion of E-cigarettes Abstinent Days by Self-report at Stage 2
Proportion of abstinent days of E- Cigarettes was measured by self-report at stage 2.
Measured: week 7, week 12
Mean Change of Depression Symptom Score by PHQ-9 at Stage 1
Patient Health Questionnaire-9 (PHQ-9) measures participants depression symptoms. Possible scores range from 0-27, with higher scores indicating a more severe depression symptoms.
PHQ-9 scores reflect depression severity, ranges from 0-27 (0 no depressive symptoms, 1-4 minimal depression, 5-9 mild depression, 10-14 moderate depression, 15-19 moderately severe depression, 20-27 severe depression)
Measured: Baseline, week 6
Mean Change of Depression Symptom Score by PHQ-9 at Stage 2
Patient Health Questionnaire-9 measures participants depression symptoms. Possible scores range from 0-27, with higher scores indicating a more severe depression symptoms.
PHQ-9 scores reflect depression severity, ranges from 0-27 (0 no depressive symptoms, 1-4 minimal depression, 5-9 mild depression, 10-14 moderate depression, 15-19 moderately severe depression, 20-27 severe depression)
Measured: week 7, week 12
Mean Change of Quality of Life (QOL) by PhenX Core Tier 1 Instrument at Stage 1
Mean change score of QOL (General health, Physical health, and Mental health) from baseline will be assessed by PhenX (Phenotypes and eXposures) Core Tier 1 instrument: Quality of Life (QOL), which measures participants' quality of life during the past 30 days. Possible scores range from 0 to 30 (number of days in the past 30 in which health was good), with higher scores indicating a better quality of life.
Measured: Baseline, Week 6
Mean Change of Quality of Life (QOL) by PhenX Core Tier 1 Instrument at Stage 2
Mean change score of QOL (General health, Physical health, and Mental health) from baseline will be assessed by PhenX Core Tier 1 instrument: Quality of Life (QOL), which measures participants' quality of life during the past 30 days. Possible scores range from 0 to 30 (number of days in the past 30 in which health was good), with higher scores indicating a better quality of life.
Measured: week 7, week 12
Mean Change of Overall Functioning as Measured by Treatment Effectiveness Assessment (TEA) at Stage 1
The Treatment Effectiveness Assessment is a 4-item self-administered assessment that uses a Likert scale (1-10) to document changes in four life domains: substance use, health, lifestyle, and community and is collected at screening, mid-treatment (Week 6 Visit 2) and end-of-treatment (Week 12 Visit 2).
Possible scores range from 4-40, with higher scores indicating a higher overall functioning.
Measured: Baseline, week 6
Mean Change of Overall Functioning as Measured by Treatment Effectiveness Assessment (TEA) at Stage 2
The Treatment Effectiveness Assessment is a 4-item self-administered assessment that uses a Likert scale (1-10) to document changes in four life domains: substance use, health, lifestyle, and community and is collected at screening, mid-treatment (Week 6 Visit 2) and end-of-treatment (Week 12 Visit 2).
Possible scores range from 4-40, with higher scores indicating a higher overall functioning.
Measured: week 7, week 12
Number of Participants Who Completed the Visit in Week 12
The number of participants in Stage 2 who completed the Week 12 visit.
Measured: At week 12
Participant Satisfaction Rating Measured by Study Satisfaction Survey at the End of the Study
The Study satisfaction survey measures the satisfaction with their study experience for participants who completed the Week 12 visit.. Ratings were:
- Very Dissatisfied
- Dissatisfied
- Neither
- Satisfied
- Very Satisfied
Measured: At week 12
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted13 Mar 2017
- Study start5 May 2017
- Primary completion3 Jul 2019
- Study completion25 Jul 2019
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Posted resultsParticipant flow, outcome measures and adverse events reported by the sponsor.
- Publications (9)Papers the sponsor has linked to this study.
- Other trials for Methamphetamine Use DisorderStudies of the same condition, open and under way.
- More trials run by University of Texas Southwestern Medical CenterThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase 3
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Sequential
- Model description
- During the study, participants may or may not be switched to another group due to the adaptive aspect of the study design. Participants appearing to respond well to their original treatment assignment will not be switched.
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 403 participants (actual)
Sponsor and investigators
- Lead sponsor
- University of Texas Southwestern Medical Center
- Sponsor type
- University, hospital or other
- Collaborators
- National Institute on Drug Abuse (NIDA), The Emmes Company, LLC
- Responsible party
- Principal investigator, Madhukar H. Trivedi, MD, University of Texas Southwestern Medical Center
- Investigators
- Madhukar Trivedi, MD, Principal investigator, University of Texas Southwestern Medical Center
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT03078075
- Sponsor's protocol ID
- CTN-0068
- Other IDs
- UG1DA020024
- Acronym
- ADAPT-2
- Status last verified
- Oct 2026
- First submitted
- 2 Mar 2017
- Last updated
- 27 Oct 2026
- Results posted
- Yes, on ClinicalTrials.gov
- Data monitoring committee
- Yes
- FDA-regulated drug
- Yes
- FDA-regulated device
- No
- Individual data sharing
- Yes: Data from this study will be available to researchers on the website https://datashare.nida.nih.gov/ after the study is complete and the data is analyzed. This website will not include information that can identify individual study participants.The following information will be posted: Study protocol, reference to study publication of primary outcome, data sets (SAS and ASCII ), annotated case report forms, define file (also known as Data Dictionary), study-specific de-identification notes. Prior to downloading any study data, the user will be prompted to complete a registration agreement for data use. Users will have to register a name and valid e-mail address in order to download data and to accept their responsibility for using data in accordance with the NIDA Data Share Agreement.
Publications
Trivedi MH, Walker R, Ling W, Dela Cruz A, Sharma G, Carmody T, Ghitza UE, Wahle A, Kim M, Shores-Wilson K, Sparenborg S, Coffin P, Schmitz J, Wiest K, Bart G, Sonne SC, Wakhlu S, Rush AJ, Nunes EV, Shoptaw S. Bupropion and Naltrexone in Methamphetamine Use Disorder. N Engl J Med. 2021 Jan 14;384(2):140-153. doi: 10.1056/NEJMoa2020214.
PubMed 33497547Mojtabai R, Susukida R, Farokhnia M, Nguyen TQ, Leggio L, Bergeria C, Prasad S, Dunn KE, Amin-Esmaeili M. Mediators of treatment response in a clinical trial of naltrexone and bupropion for methamphetamine use disorder: A longitudinal mediation analysis. J Psychopharmacol. 2026 Jul 26:2698811261464533. doi: 10.1177/02698811261464533. Online ahead of print.
PubMed 42504048Mojtabai R, Susukida R, Farokhnia M, Nguyen TQ, Leggio L, Bergeria C, Prasad S, Dunn KE, Amin-Esmaeili M. Mediators of Treatment Response in Clinical Trial of Naltrexone and Bupropion for Methamphetamine Use Disorder: A Longitudinal Mediation Analysis. medRxiv [Preprint]. 2026 May 13:2026.05.09.26352807. doi: 10.64898/2026.05.09.26352807.
PubMed 42180350Jha MK, Ghitza UE, Shoptaw S, Minhajuddin A, Kuruvila S, Wakhlu S, Nunes EV, Schmitz J, Coffin PO, Bart G, Carmody T, Trivedi MH. Early Change in Depressive Symptom Severity With Naltrexone-Bupropion Combination and Its Association With Reduction in Methamphetamine Use in ADAPT-2 Trial. J Clin Psychiatry. 2025 Jul 30;86(3):25m15825. doi: 10.4088/JCP.25m15825.
PubMed 40767786Jha MK, Ghitza UE, Carmody T, Kuruvila S, Shoptaw S, Minhajuddin A, Wakhlu S, Schmitz JM, Coffin PO, Bart G, Nunes EV, Kenny P, Trivedi MH. Craving, Impulsivity, and Subsequent Methamphetamine Use With Naltrexone-Bupropion Versus Placebo: Findings From a Randomized Clinical Trial. J Addict Med. 2026 Mar-Apr 01;20(2):214-222. doi: 10.1097/ADM.0000000000001538. Epub 2025 Jul 7.
PubMed 40623319Li MJ, Chau B, Belin T, Carmody T, Jha MK, Marino EN, Trivedi M, Shoptaw SJ. Extended observation of reduced methamphetamine use with combined naltrexone plus bupropion in the ADAPT-2 trial. Addiction. 2024 Oct;119(10):1840-1845. doi: 10.1111/add.16529. Epub 2024 Jun 10.
PubMed 38856086Okafor CN, Carmody T, Stotts AL, Bart G, Mayes TL, Karns-Wright T, Trivedi M, Shoptaw S, Potter JS. Sociodemographic and patient reported outcomes by racial and ethnicity status among participants in a randomized controlled trial for methamphetamine use disorder. Drug Alcohol Depend Rep. 2024 Apr 6;11:100230. doi: 10.1016/j.dadr.2024.100230. eCollection 2024 Jun.
PubMed 38665252Trombello JM, Kulikova A, Mayes TL, Nandy K, Carmody T, Bart G, Nunes EV, Schmitz J, Kalmin M, Shoptaw S, Trivedi MH. Psychometrics of the Concise Health Risk Tracking Self-Report (CHRT-SR16) Assessment of Suicidality in a Sample of Adults with Moderate to Severe Methamphetamine Use Disorder: Findings from the ADAPT-2 Randomized Trial. Neuropsychiatr Dis Treat. 2023 Jun 22;19:1443-1454. doi: 10.2147/NDT.S406909. eCollection 2023.
PubMed 37377462Vo HT, Kulikova A, Mayes TL, Carmody T, Shoptaw S, Ling W, Trombello JM, Trivedi MH. Psychometric properties of the Treatment Effectiveness Assessment in methamphetamine use disorder. J Subst Use Addict Treat. 2023 Aug;151:209085. doi: 10.1016/j.josat.2023.209085. Epub 2023 May 26.
PubMed 37245855
Study at a glance
From the registry record, last updated by the sponsor on 27 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- NIDA (National Institute on Drug Abuse) CTN (Clinical Trials Network) Protocol 0068: Accelerated Development of Additive Pharmacotherapy Treatment (ADAPT-2) for Methamphetamine Use Disorder
- ClinicalTrials.gov ID
- NCT03078075
- Acronym / sponsor ID
- ADAPT-2 / CTN-0068
- Conditions
- Methamphetamine Use Disorder
- Keywords
- Methamphetamine, Methamphetamine Use Disorder, Naltrexone, Bupropion, Vivitrol®
- Phase
- Phase 3
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 403 participants (actual)
- Lead sponsor
- University of Texas Southwestern Medical CenterUniversity, hospital or other
- Collaborators
- National Institute on Drug Abuse (NIDA), The Emmes Company, LLC
- Study start
- 5 May 2017 (actual)
- Primary completion
- 3 Jul 2019 (actual)
- Study completion
- 25 Jul 2019 (actual)
- First posted
- 13 Mar 2017 (actual)
- Results
- Posted 29 Mar 2021
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a double-blind, placebo-controlled, randomized clinical trial evaluating the efficacy of extended-release naltrexone plus bupropion as a combination pharmacotherapy for methamphetamine use disorder. Participants will be randomly assigned to the active medication combination (AMC) group or matching placebo group and will receive medications over the course of 12 weeks. Follow-ups will occur in weeks 13 and 16.
Detailed description
There will be 400 adults with moderate or severe methamphetamine use disorder randomized into this multi-site study. Eligibility will be determined during a maximum 21 day screening period. After screening is completed and eligibility is confirmed, including successful administration of a naloxone challenge, participants will begin the 12 week medication phase of the trial. Participants will be randomized to either the 1) AMC arm and receive injections of extended release naltrexone (XR-NTX; as Vivitrol®) plus once-daily oral extended-release bupropion tablets (BUP-XL) or the 2) matching placebo (PLB) arm and receive injections of placebo (iPLB) plus once-daily oral placebo (oPLB) tablets. During the course of the study, participants may be switched to another arm, as determined by the a priori adaptive aspect of the study design. Participants appearing to respond well to their original treatment assignment will not be switched. Overall, approximately 50% of the participants will receive the AMC. Injections will be administered every three weeks, in weeks 1, 4, 7, and 10. Take-home oral study medication (BUP-XL or oPLB) will be dispensed weekly for dosing on non-clinic days. Participants will be asked to attend the clinic twice weekly for observed oral medication dosing, assessments, collection of urine samples, and once-weekly medical management. On non-clinic days, participants will participate in smartphone app-based medication adherence activities. Participants will be asked to complete assessments as indicated on the schedule of assessments. Following the 12 week medication phase, participants will complete a follow-up phase, including a medication taper and post-medication phase follow-up visits during weeks 13 and 16.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Sequential
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
- Model description
- During the study, participants may or may not be switched to another group due to the adaptive aspect of the study design. Participants appearing to respond well to their original treatment assignment will not be switched.
| Arm | Type | Receives |
|---|---|---|
| Active Medication Combination (AMC) | Experimental | Drug: Naltrexone: Vivitrol®, Drug: Bupropion: Wellbutrin XL®injectable extended release naltrexone plus once daily oral extended-release bupropion tablets |
| Matched Placebo (PLB) | Placebo comparator | Drug: Placebo (PLB) Injectable, Drug: Placebo (PLB) Oralinjectable matching placebo plus once-daily oral placebo tablets |
Who may qualify
- Ages
- 18 to 65 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (7 listed)
- 18 to 65 years old;
- Interested in reducing/stopping methamphetamine use;
- Speak English;
- Agree to use acceptable birth control (if applicable);
- Be opioid-free at randomization;
Key exclusion criteria (6 listed)
- Medical or psychiatric condition which would make participation unsafe;
- Recently participated in a study of pharmacological or behavioral treatment for methamphetamine use disorder;
- Recently taken an investigational drug;
- Prescribed and taken naltrexone or bupropion ≤ 30 days from consent;
- Current or planned extended absence during study period (e.g., jail, surgery, pending legal action);
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Naltrexone: Vivitrol®Also: Arm: Experimental - Active Medication Combination (AMC)Naltrexone: 380 mg vial, 4 intramuscular injections administered every 3 weeks | Drug | Active Medication Combination (AMC) |
| Placebo (PLB) InjectableAlso: Injectable matching (to Naltrexone) placebo, Arm: Placebo Comparator - matched Placebo (PLB)Placebo: 4 intramuscular injections administered every 3 weeks | Drug | Matched Placebo (PLB) |
| Bupropion: Wellbutrin XL®Also: Arm: Experimental - Active Medication Combination (AMC)Bupropion: 450 mg oral dose daily | Drug | Active Medication Combination (AMC) |
| Placebo (PLB) OralAlso: Oral matching (to Bupropion) placebo tablets, Arm: Placebo Comparator - matched Placebo (PLB)Placebo: once-daily oral placebo tablets | Drug | Matched Placebo (PLB) |
Primary outcome
Number of Participants With Treatment Response During Medication Phase at Stage 1
Time frame: At week 6
Treatment response is defined as 'Responder' and 'Non-Responder'. Responder : Participant who meets responder criterion by providing at least 3 out of a possible 4 methamphetamine-negative urine tests at the end of stage 1 (weeks 5-6). Non-Responder: All other participants without 3 or 4 methamphetamine-negative urine drug test.
Number of Participants in Placebo Arm With Treatment Response During Medication Phase at Stage 2
Time frame: At week 12
Treatment response is defined as 'Responder' and 'Non-Responder'. Responder : Participant who meet responder criterion by providing at least 3 out of a possible 4 methamphetamine-negative urine drug screens (UDS) at the end of stage 2 (weeks 11-12). Non-Responder: All other participants without 3 or 4 methamphetamine-negative UDS.
Number of Participants With Treatment Response During Medication Phase at Stage 1 (by Race)
Time frame: At week 6
Treatment response is defined as 'Responder' and 'Non-Responder'. Responder : Participant who meet responder criterion by providing at least 3 out of a possible 4 methamphetamine-negative urine tests at the end of stage 1 (weeks 5-6). Non-Responder: All other participants without 3 or 4 methamphetamine-negative UDS (Urine Drug Screen). Race: Black, White, Other
Number of Participants With Treatment Response During Medication Phase at Stage 1 (by Ethnicity)
Time frame: At Week 6
Treatment response is defined as 'Responder' and 'Non-Responder'. Responder : Participant who meets responder criterion by providing at least 3 out of a possible 4 methamphetamine negative urine tests at the end of stage 1 (weeks 5-6). Non-Responder: All other participants without 3 or 4 methamphetamine-negative UDS (Urine Drug Screen). Ethnicity: Hispanic, Non-Hispanic/Other
Number of Participants With Treatment Response During Medication Phase at Stage 1 (by Sex)
Time frame: At week 6
Treatment response is defined as 'Responder' and 'Non-Responder'. Responder : Participant who meet responder criterion by providing at least 3 out of a possible 4 methamphetamine-negative urine tests at the end of stage 1 (weeks 5-6). Non-Responder: All other participants without 3 or 4 methamphetamine-negative UDS (Urine Drug Screen). Sex: Female, Male
Number of Participants With Treatment Response During Medication Phase at Stage 2 (by Race)
Time frame: At week 12
Treatment response is defined as 'Responder' and 'Non-Responder'. Responder : Participant who meet responder criterion by providing at least 3 out of a possible 4 methamphetamine-negative urine tests at the end of stage 2 (weeks 11-12). Non-Responder: All other participants without 3 or 4 methamphetamine-negative UDS (Urine Drug Screen). Race: Black, White, Other
Number of Participants With Treatment Response During Medication Phase at Stage 2 (by Ethnicity)
Time frame: at Week 12
Treatment response is defined as 'Responder' and 'Non-Responder'. Responder : Participant who meets responder criterion by providing at least 3 out of a possible 4 methamphetamine negative urine tests at the end of stage 2 (weeks 11-12). Non-Responder: All other participants without 3 or 4 methamphetamine-negative UDS (Urine Drug Screen). Ethnicity: Hispanic, Non-Hispanic/Other
Number of Participants With Treatment Response During Medication Phase at Stage 2 (by Sex)
Time frame: At week 12
Treatment response is defined as 'Responder' and 'Non-Responder'. Responder : Participant who meet responder criterion by providing at least 3 out of a possible 4 methamphetamine-negative urine tests at the end of stage 2 (weeks 11-12). Non-Responder: All other participants without 3 or 4 methamphetamine-negative UDS (Urine Drug Screen). Sex: Female, Male
27 secondary outcomes
Treatment Effectiveness Score of Participants at Stage 1
Time frame: At weeks 6
Treatment Effectiveness Score of Participants at Stage 2
Time frame: At week 12
Percentage of Participants Who Used Methamphetamine in the Pre-evaluation Period
Time frame: Weeks 1-4 and Weeks 7-10
Mean Maximum Number of Consecutive Visits Negative UDS at Stage 1
Time frame: At week 6
Mean Maximum Number of Consecutive Visits Negative UDS at Stage 2
Time frame: At week 12
Mean Number of Study Weeks With Two Methamphetamine-negative UDS at Stage 1
Time frame: At week 6
Mean Number of Study Weeks With Two Methamphetamine-negative UDS at Stage 2
Time frame: At week12
Mean Change of Percentage of Methamphetamine Abstinent Days Measured by Self-report at Stage 1
Time frame: Baseline, week 6
Mean Change Percentage of Methamphetamine Abstinent Days Measured by Self-report at Stage 2
Time frame: week 7, week 12
Mean Change of Methamphetamine Craving at Stage 1
Time frame: Baseline, week 6
Mean Change of Methamphetamine Craving at Stage 2
Time frame: week 7, week 12
Mean Number of Abstinent Days of Participants Who Used Other Substance Measured by UDS at Stage 1
Time frame: At week 6
Mean Number of Abstinent Days of Participants Who Used Other Substance Measured by UDS at Stage 2
Time frame: at week 12
Mean Change of Proportion of Other Substance Abstinent Days Measured by Self-report at Stage 1
Time frame: Baseline, week 6
Mean Change of Proportion of Other Substance Abstinent Days Measured by Self-report at Stage 2
Time frame: week 7, week 12
Mean Change in Number of Other Substance Use by Self-report at Stage 1
Time frame: Baseline, week 6
Mean Change in Number of Other Substance Use by Self-report at Stage 2
Time frame: week 7, week 12
Change in Proportion of E-cigarettes Abstinent Days by Self-report at Stage 1
Time frame: Baseline, week 6
Change in Proportion of E-cigarettes Abstinent Days by Self-report at Stage 2
Time frame: week 7, week 12
Mean Change of Depression Symptom Score by PHQ-9 at Stage 1
Time frame: Baseline, week 6
Mean Change of Depression Symptom Score by PHQ-9 at Stage 2
Time frame: week 7, week 12
Mean Change of Quality of Life (QOL) by PhenX Core Tier 1 Instrument at Stage 1
Time frame: Baseline, Week 6
Mean Change of Quality of Life (QOL) by PhenX Core Tier 1 Instrument at Stage 2
Time frame: week 7, week 12
Mean Change of Overall Functioning as Measured by Treatment Effectiveness Assessment (TEA) at Stage 1
Time frame: Baseline, week 6
Mean Change of Overall Functioning as Measured by Treatment Effectiveness Assessment (TEA) at Stage 2
Time frame: week 7, week 12
Number of Participants Who Completed the Visit in Week 12
Time frame: At week 12
Participant Satisfaction Rating Measured by Study Satisfaction Survey at the End of the Study
Time frame: At week 12
Results and safety
Loading the posted results from ClinicalTrials.gov…
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 27 Oct 2026.
- Posted resultsParticipant flow, baseline, all outcome measures and adverse events.
- Results publication: PubMed 33497547Trivedi MH, Walker R, Ling W, Dela Cruz A, Sharma G, Carmody T, Ghitza UE, Wahle A, Kim M, Shores-Wilson K, Sparenborg S, Coffin P, Schmitz J, Wiest K, Bart G, Sonne SC, Wakhlu S, Rush AJ, Nunes EV, Shoptaw S. Bupropion and Naltrexone in Methamphetamine Use Disorder. N Engl J Med. 2021 Jan 14;384(2):140-153. doi: 10.1056/NEJMoa2020214.
- Derived from this study: PubMed 42504048Mojtabai R, Susukida R, Farokhnia M, Nguyen TQ, Leggio L, Bergeria C, Prasad S, Dunn KE, Amin-Esmaeili M. Mediators of treatment response in a clinical trial of naltrexone and bupropion for methamphetamine use disorder: A longitudinal mediation analysis. J Psychopharmacol. 2026 Jul 26:2698811261464533. doi: 10.1177/02698811261464533. Online ahead of print.
- Derived from this study: PubMed 42180350Mojtabai R, Susukida R, Farokhnia M, Nguyen TQ, Leggio L, Bergeria C, Prasad S, Dunn KE, Amin-Esmaeili M. Mediators of Treatment Response in Clinical Trial of Naltrexone and Bupropion for Methamphetamine Use Disorder: A Longitudinal Mediation Analysis. medRxiv [Preprint]. 2026 May 13:2026.05.09.26352807. doi: 10.64898/2026.05.09.26352807.
- Derived from this study: PubMed 40767786Jha MK, Ghitza UE, Shoptaw S, Minhajuddin A, Kuruvila S, Wakhlu S, Nunes EV, Schmitz J, Coffin PO, Bart G, Carmody T, Trivedi MH. Early Change in Depressive Symptom Severity With Naltrexone-Bupropion Combination and Its Association With Reduction in Methamphetamine Use in ADAPT-2 Trial. J Clin Psychiatry. 2025 Jul 30;86(3):25m15825. doi: 10.4088/JCP.25m15825.
- Derived from this study: PubMed 40623319Jha MK, Ghitza UE, Carmody T, Kuruvila S, Shoptaw S, Minhajuddin A, Wakhlu S, Schmitz JM, Coffin PO, Bart G, Nunes EV, Kenny P, Trivedi MH. Craving, Impulsivity, and Subsequent Methamphetamine Use With Naltrexone-Bupropion Versus Placebo: Findings From a Randomized Clinical Trial. J Addict Med. 2026 Mar-Apr 01;20(2):214-222. doi: 10.1097/ADM.0000000000001538. Epub 2025 Jul 7.
- Derived from this study: PubMed 38856086Li MJ, Chau B, Belin T, Carmody T, Jha MK, Marino EN, Trivedi M, Shoptaw SJ. Extended observation of reduced methamphetamine use with combined naltrexone plus bupropion in the ADAPT-2 trial. Addiction. 2024 Oct;119(10):1840-1845. doi: 10.1111/add.16529. Epub 2024 Jun 10.
- Derived from this study: PubMed 38665252Okafor CN, Carmody T, Stotts AL, Bart G, Mayes TL, Karns-Wright T, Trivedi M, Shoptaw S, Potter JS. Sociodemographic and patient reported outcomes by racial and ethnicity status among participants in a randomized controlled trial for methamphetamine use disorder. Drug Alcohol Depend Rep. 2024 Apr 6;11:100230. doi: 10.1016/j.dadr.2024.100230. eCollection 2024 Jun.
- Derived from this study: PubMed 37377462Trombello JM, Kulikova A, Mayes TL, Nandy K, Carmody T, Bart G, Nunes EV, Schmitz J, Kalmin M, Shoptaw S, Trivedi MH. Psychometrics of the Concise Health Risk Tracking Self-Report (CHRT-SR16) Assessment of Suicidality in a Sample of Adults with Moderate to Severe Methamphetamine Use Disorder: Findings from the ADAPT-2 Randomized Trial. Neuropsychiatr Dis Treat. 2023 Jun 22;19:1443-1454. doi: 10.2147/NDT.S406909. eCollection 2023.
- Derived from this study: PubMed 37245855Vo HT, Kulikova A, Mayes TL, Carmody T, Shoptaw S, Ling W, Trombello JM, Trivedi MH. Psychometric properties of the Treatment Effectiveness Assessment in methamphetamine use disorder. J Subst Use Addict Treat. 2023 Aug;151:209085. doi: 10.1016/j.josat.2023.209085. Epub 2023 May 26.
- Individual participant dataSharing planned: Yes. Data from this study will be available to researchers on the website https://datashare.nida.nih.gov/ after the study is complete and the data is analyzed. This website will not include information that can identify individual study participants.The following information will be posted: Study protocol, reference to study publication of primary outcome, data sets (SAS and ASCII ), annotated case report forms, define file (also known as Data Dictionary), study-specific de-identification notes. Prior to downloading any study data, the user will be prompted to complete a registration agreement for data use. Users will have to register a name and valid e-mail address in order to download data and to accept their responsibility for using data in accordance with the NIDA Data Share Agreement.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Madhukar Trivedi, MD principal investigator
University of Texas Southwestern Medical Center
8 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A Phase 3 study testing Naltrexone: Vivitrol® and Bupropion: Wellbutrin XL® in people with Methamphetamine Use Disorder, run by University of Texas Southwestern Medical Center at 8 sites in United States.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 7 inclusion and 6 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 27 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 8 sites in United States. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
What does this phase mean?
Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.
Not every study follows the same path, and some studies (observational studies, device studies) have no phase.
Are results available for this study?
Yes. Results are posted in the registry (first posted 29 Mar 2021). A summary is in the For doctors view, and the full results are on ClinicalTrials.gov.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Number of Participants With Treatment Response During Medication Phase at Stage 1 (time frame: At week 6). The study lists 8 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT03078075, which also lists 9 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 27 Oct 2026.