Successful Treatment of Methamphetamine Use Disorder Using Oral Naltrexone and Bupropion: A Case Report

Background: Methamphetamine use disorder (MUD) remains a significant challenge due to the absence of approved pharmacological treatments.Recent studies have shown promise in combining naltrexone and bupropion to reduce craving and use. Case presentation:We report the case of a 41-year-old single male with severe methamphetamine dependence who presented with daily intravenous use, self-neglect, paranoia and auditory hallucinations.He had no prior psychiatric or medical history.Treatment with oral naltrexone 50 mg daily and bupropion extended-release 150 mg daily was initiated, alongside regular followup every two weeks.Over the following months, his methamphetamine use progressively decreased, cravings diminished and psychotic features resolved.After six months, he achieved complete abstinence for three consecutive months, with no relapse or significant side effects.Conclusion: This case supports the emerging evidence for the combination of naltrexone and bupropion in the management of methamphetamine use disorder.Oral formulations may be a practical and accessible alternative where injectable naltrexone is unavailable.Further clinical studies are warranted.