Published: 04/20/2026 | Author: Terri

A recent clinical trial has produced the strongest evidence yet that a common generic antidepressant can help reduce methamphetamine use. This is a significant development in narcotic addiction treatment as no FDA-approved medication currently exists for the disorder.

An impressive array of programs and services already addresses many facets of addiction, from grassroots Narcotics Anonymous peer support groups to inpatient care. However, these new findings offer a potential foothold in treating stimulant use disorder without a single approved pharmacological option.

The Opioid Crisis & the Broader Narcotics Epidemic

While fentanyl and opioid addiction have dominated public health headlines for over a decade, methamphetamine use has surged in parallel. Indeed, the two even overlap as illicit drug markets regularly involve polysubstance use. Deaths involving both methamphetamine and synthetic opioids like fentanyl have become alarmingly common in overdose data.

Yet unlike available medication assisted treatment for opioid addictions, methamphetamine use disorder has had no equivalent. Instead, providers have opted for psychosocial counseling, behavioral therapy and peer support. These approaches are effective, but limited.

The Mirtazapine Trial’s Findings

That’s where this new study comes in. From November 2022 to May 2025, six outpatient alcohol and drug clinics in Australia enrolled 339 adults with moderate to severe methamphetamine use disorder. These participants had used methamphetamine for around 24 days out of a month.

Led by Dr. Rebecca McKetin of the National Drug and Alcohol Research Centre at the University of New South Wales Sydney, the team learned that those who took mirtazapine stayed off meth for around 7 days, two days longer when compared to those who took the placebo.

“The exciting thing about our finding is that we’re able to confirm that mirtazapine, this generic antidepressant that’s widely available and quite cheap, can actually help people to reduce their methamphetamine use,” McKetin noted, adding that the drug has a “well-established safety profile.”

Narcotic Addiction Treatment & the FDA Approval Gap

Mirtazapine is already approved as an antidepressant and widely available as a low-cost generic. The medication addresses a key driver of relapse. Patients who attempt to quit methamphetamine often face severe mood swings, depression, and insomnia that push them back toward use and discourage them from trying to quit again. Mirtazapine’s sedating and mood-stabilizing properties may blunt those withdrawal symptoms enough to interrupt the cycle.

“At the moment, all of the treatment options we’ve got are psychosocial, and can be difficult to access,” McKetin noted. For general practitioners, she said, they can use mirtazapine “to help people who want to reduce their methamphetamine use, in addition to using it for depression, and they can do that fairly safely.”

Important Limitations

The trial’s authors were candid about the modest scope of the effect. McKetin acknowledged it showed “quite a small effect” on methamphetamine use, and noted that secondary depression, insomnia, HIV risk behavior, and quality of life showed no significant improvement.

Treatment effects were also impacted by side effects. Almost 25% of the mirtazapine participants stopped taking the drug due to side effects, compared to 15% on placebo. The most common adverse effects were drowsiness and weight gain.

“As researchers, we need to come up with something that has a stronger impact and a larger treatment effect,” McKetin observed.

What This Means for People in Recovery

For individuals navigating narcotic addiction, this research underscores how recovery is a medical process, not a moral failure, and the science of treating it continues to evolve. The most durable recoveries typically combine pharmacological support with peer connection, behavioral therapy, and community.

Narcotics Anonymous meetings offer exactly that kind of sustained peer support. Meetings are free, accessible, and available every day. For anyone with methamphetamine or opioid addiction, NA meetings provide a space to build the human connections that make long-term recovery possible.

To find an NA meeting near your location, take a look through our directory or call 800-934-1582(Sponsored) to get started and to explore options for recovery.