Abstract
Methamphetamine is the drug of choice for the majority of problem drug users in the Czech Republic. The treatment of methamphetamine dependence is exclusively abstinence-oriented.
Pharmacological therapy of methamphetamine dependence has been broadly discussed in the recent literature. In the Czech Republic, however, no substitution drug has yet been approved for treatment practice.
The case study presents a woman with a university degree, professionally well-established, successful, and without a steady partner, who was admitted to the programme at the age of 33. She began using phentermine when she was 27 and converted to methamphetamine at the age of 28.
She used it by sniffing only. On admission, she reported daily methamphetamine use, 0.3-0.4 g per day.
In terms of diagnosis, she showed evident signs of a depressive disorder, partially stabilised by medication, methamphetamine dependence, active abuse, alcohol abuse with suspected dependence, and suspected ADHD (Attention Deficit Hyperactivity Disorder). Methylphenidate was administered at an initial dose of 10 mg per day, with a recommendation to increase the dose as needed to achieve the optimum effects (not exceeding a daily dose of 60 mg, while maintaining the maximum permissible rate of a 10 mg daily increase).
At the follow-up appointment a week later the dose was raised to 40 mg per day and 10 days after the first administration of the medication she reached the maximum daily dose of 60 mg (3-2-1). The patient has been abstaining from methamphetamine for a long time (30 months).
Full remission has been achieved. The patient found the impact of methylphenidate on her treatment significant.
The withdrawal of methylphenidate was seen by the patient as causing no problems.