This page shows what was measured, who it was measured in, and what that does not settle.
What Metamfetamine does in the body
ADHD in children over six, as one part of a wider treatment plan. The label also carries a short-term weight-loss indication that is essentially never used
Cocaine plugs the dopamine pump. Methamphetamine does something more forceful: it is carried into the nerve terminal by the pump, empties dopamine out of the storage vesicles into the cell interior, and then runs the pump backwards so the dopamine floods out into the synapse. The consequence is a much larger and much longer-lasting release than a reuptake blocker can produce, and it also leaves dopamine sitting in the cytoplasm where it oxidises — which is the leading explanation for why heavy use damages the terminals themselves rather than just overstimulating them.
What happened in people
FDA approval since 31 December 1943 for ADHD in children over 6 and short-term adjunctive treatment of exogenous obesity
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The recorded finding that sits closest to something a person would notice. Written into the record, not signed off, and it carries no population or interval.
That neurotoxicity documented in heavy smoked or injected use describes the risk of therapeutic oral dosing, or vice versa
Where it acts
Dopaminergic terminals of the striatum and nucleus accumbens; noradrenergic terminals throughout
Kind of result
The kind of result is not recorded
Supervision
Professional supervision is normally required. A regulator classifies this substance in a way that restricts how it is supplied.
What the registries record it as
7 registered substances share the start of this name, which is why a search for it can return more than one thing.
FDA substance registry · 24GNZ56D62 · read 2026-08-29
Where each sentence above came from
No recorded sentence describes the change this makes in a way that stands on its own. The page opens with what it is taken for instead, and the recorded explanation follows below.
Shown as the opening line on this page.
A limit recorded against this substance. Not signed off as a reviewed claim.
The four opening statements run to 138 words.
Words this page uses
Four words worth knowing first
Chosen from what this page shows, with each one explained before the word it depends on.
Biomarker
A biomarker is a number from a test that stands in for something about health.
A picture of it, and where the picture fails
A biomarker is like a fuel gauge.
Where that stops being true. A gauge is wired to the tank. Many biomarkers are only loosely tied to health.
What people get wrong. A better number is read as a better life. Several medicines improved a number and helped nobody.
A measurable indicator used as a substitute for a clinical outcome of interest.
Stand-in result
A stand-in result is a number measured because the real result takes too long.
A picture of it, and where the picture fails
It is like judging a journey by the speedometer rather than by arriving.
Where that stops being true. Speed does predict arrival. Many stand-in results do not predict the real one.
What people get wrong. A stand-in result is often reported as the result itself.
A surrogate endpoint substituted for a clinical endpoint, valid only where the substitution has been shown to hold.
What happened in people◇Read from sources, not yet reviewed
What was measured, goal by goal
One row for each goal a registered study measured something for. One column for each kind of thing that could be measured.
Registered studies list 7 outcome measures that RNAWiki could read. A registered study says what someone planned to measure. It does not say what they found. 0 of the matched studies tested this substance, and 0 posted a result.
There is no single score. A strong test result and a weak life result are different facts.
Goals down the side, kinds of measurement across the top. Each cell says what kind of thing was registered, not what was found.
Goal
Life outcome
What a body can do
How a person feels
A test result
A step in the body
Harms
How long
Who was studied
Focus
∅Nothing in the sources checkedNo registered study lists a life outcome for this goal.
…Waiting for a reviewer1 registered performance measure of this kind.
∅Nothing in the sources checkedNo registered study lists a symptom measure for this goal.
∅Nothing in the sources checkedNo registered study lists a test result for this goal.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Mood
∅Nothing in the sources checkedNo registered study lists a life outcome for this goal.
∅Nothing in the sources checkedNo registered study lists a performance measure for this goal.
…Waiting for a reviewer1 registered symptom measure.
∅Nothing in the sources checkedNo registered study lists a test result for this goal.
∅Nothing in the sources checkedNo registered study lists a body-step measure for this goal.
—Not recordedHarms were not a registered measure for this goal.
—Not recordedNo finished study window is recorded.
…Waiting for a reviewerWho was studied is listed further down the page.
Which registered measures put each goal on this table
Focus
cognitive function
Mood
profile of mood states
Sorted by fixed word lists, version v1. A name the rules do not recognise stays unsorted rather than moving to the nearest column.
What each mark on this table means
∅ Nothing in the sources checked
No registered study lists a life outcome for this goal.
… Waiting for a reviewer
1 registered performance measure of this kind.
— Not recorded
Harms were not a registered measure for this goal.
What happened in people◇Read from sources, not yet reviewed
What happened in people
Each card is one study: the exact question it asked, who was in it, and whether it showed what it set out to show.
Response — at least 3 of 4 methamphetamine-negative urine samples at the end of stage 1 or stage 2
Weighted response 13.6% vs 2.5%, treatment effect 11.1 percentage points, Wald z = 4.53, P<0.001
Repeated elsewhere
Unreplicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. Serious adverse events in 8 of 223 (3.6%) receiving naltrexone-bupropion. The absolute response rate of 13.6% is low, and the trial has not produced an approved product.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral tablet, once daily, in the approved product
Interval reported. Not recorded in this summary
Written into the record, not signed off as a reviewed claim.
Drugs@FDA: DESOXYN (methamphetamine hydrochloride) tablets, NDA 005378, original approval 31 December 1943 (https://www.accessdata.fda.gov/scripts/cder/daf/i… · a recorded source, not a stored snapshot
Striatal dopamine transporter availability, and its association with psychomotor and memory performance
✓ The study showed what it set out to show
Who was studied
Volkow PET series, dopamine transporter availability in methamphetamine abusers
How many people
15
Study design
Imaging case-control with longitudinal abstinence follow-up
Compared against
Not recorded for this study
Kind of result
A number that stands in for health
What was found
Significant DAT reduction versus controls, associated with psychomotor impairment; significant DAT recovery after more than 1 year of abstinence with incomplete functional recovery
Repeated elsewhere
Replicated
What this does not prove. Meeting one endpoint in one population does not carry to other goals or other people.
The limits of this study, and where it came from
Main limit. Small sample. PET measures transporter protein availability, which is not the same as neuron loss, and the two cannot be distinguished by this method.
How far it carries. This study is recorded from the curated record, not from the registry match.
Form and route. Oral tablet, once daily, in the approved product
Interval reported. Not recorded in this summary
Written into the record, not signed off as a reviewed claim.
Drugs@FDA: DESOXYN (methamphetamine hydrochloride) tablets, NDA 005378, original approval 31 December 1943 (https://www.accessdata.fda.gov/scripts/cder/daf/i… · a recorded source, not a stored snapshot
What we know
RNAWiki holds 2 written-up human studies for this substance, each with the question it asked.
How we know it
Each card names the study, the number of people and what the study set out to measure.
What this does not prove
These summaries were written by a person and have not been signed off as reviewed claims.
Why it matters
A study that failed is as informative as one that worked, and both are here.
What we still do not know
No reviewed claim exists, so no exact population, effect size or interval is published yet.
What happened in people◇Read from sources, not yet reviewed
How close this is to real life
The top step is something a person would feel or care about. The bottom is a guess from software. Filled steps are where evidence exists for this substance.
□Living longer, or avoiding a major eventNo evidence recorded. Death, a heart attack, a stroke, a hospital stay.No registered study measures this.
■What a body can do day to dayEvidence recorded. Walking, dressing, breathing, recovering.1 registered measure of this kind.
■Measured performanceEvidence recorded. How much was lifted, how far was run, how fast.1 registered measure of this kind.
■Symptoms and quality of lifeEvidence recorded. Pain, tiredness, mood, sleep, as the person rated it.1 registered measure of this kind.
■A number that stands in for healthEvidence recorded. Cholesterol, blood sugar, bone density. A stand-in, not the thing itself.2 registered measures of this kind.
■A step measured inside a personEvidence recorded. Something measured in human tissue or human cells.A human record sits on the stored organism ladder.
□AnimalsNo evidence recorded. Mice, rats, dogs. Useful for ideas, not proof about people.No animal record is stored.
□Cells in a dishNo evidence recorded. Cells or chemistry on a bench, far from a whole body.No cell or bench record is stored.
□A guess from softwareNo evidence recorded. Nobody measured it. RNAWiki never publishes one as a finding.RNAWiki stores no prediction for this record. Software can suggest a link. RNAWiki does not publish one as a finding.
Higher on these steps means closer to something a person would feel. It does not mean better done.
What it changes in the body◇Read from sources, not yet reviewed
The path through the body
From what a person takes to what changes. A solid line is a step measured in people. A dashed line is a step nobody has measured that way.
Start
Metamfetamine
What a person takes: Oral tablet, once daily, in the approved product.
The measurement behind this step
The prescription product is a plain oral tablet with a long half-life, giving once-daily dosing and a slow rise in brain concentration. That pharmacokinetic profile is the difference between the medicine and the street drug: the reinforcing effect of a releaser depends on how fast dopamine efflux rises, and an oral tablet raises it slowly.
Getting in
Swallowed as a tablet, or smoked, insufflated or injected
The medicine is a tablet taken once a day. Illicit use is usually smoked or injected, which puts a much larger amount into the brain much faster.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Oral absorption is good with a long elimination half-life of roughly 10 hours, so the prescription tablet is once-daily. Smoked or intravenous routes produce peak brain concentrations within minutes at far higher magnitude. About 62% of an oral dose is eliminated in urine within 24 hours, roughly a third as intact drug.
Enters the brain and then enters the nerve terminal
It crosses into the brain easily, and then is carried inside the dopamine-releasing nerve endings by the very pump it is going to sabotage.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
High lipophilicity gives rapid blood-brain barrier penetration; methamphetamine is then translocated into presynaptic terminals as a substrate of DAT and NET, and diffuses across membranes as a weak base.
Empties the storage vesicles and reverses the pump
Inside the terminal it dumps dopamine out of its storage packets into the cell fluid, then makes the pump run backwards so it pours into the synapse.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Disrupts the vesicular pH gradient and acts at VMAT2, releasing vesicular dopamine into the cytosol; then reverses DAT to produce carrier-mediated efflux. The result is a far larger and longer-lasting synaptic dopamine elevation than a reuptake blocker such as cocaine produces.
Cytoplasmic dopamine oxidises, and the terminal is damaged
Dopamine sitting outside its storage packets breaks down into reactive chemicals. That, rather than the stimulation itself, is the leading explanation for the damage seen in heavy users.
──Measured in people. Written by a person from the study named beside the step. Not signed off as a reviewed claim.
The measurement behind this step
Cytosolic dopamine auto-oxidises to quinones and reactive oxygen species, with hyperthermia and glutamate excitotoxicity as contributing factors in animal models. PET imaging in heavy human users shows reduced striatal DAT availability that partially recovers with abstinence over more than a year, while task performance recovers incompletely.
ADHD symptoms stabilise, or dependence and cardiovascular injury develop
At therapeutic doses the label's endpoint is a stabilising effect on attention and impulsivity. At heavy exposure the outcomes are dependence, psychosis and heart damage.
╌╌Described, with no measurement named. No measurement is named for this step, so it is drawn as an unconfirmed link.
The measurement behind this step
Labelled endpoint is stabilisation of distractibility, attention span, hyperactivity, emotional lability and impulsivity in children over 6. At heavy exposure: stimulant psychosis, methamphetamine-associated cardiomyopathy, and the transporter changes measured by PET. The label states that misuse may cause sudden death and serious cardiovascular adverse events.
No suggested links are held for this record, so nothing is hidden from this path.
What we know
The record describes 5 steps from taking it to an effect in a person.
How we know it
Each step names the study behind it in the technical detail beside it.
What this does not prove
A change inside the body is a reason to look. It is not a result in a person.
Why it matters
A reader can see exactly where the chain stops being measured in people.
What we still do not know
No reviewed claim binds any of these steps to a named population.
What it would be like to take◇Read from sources, not yet reviewed
Felt, measured, or meaningful
Three different things that get called the same word. Registered studies measured all three, and mixing them is how a blood test becomes a health claim.
Felt
Things a person could notice without a test.
profile of mood states
Measured
Things only a test, a scale or a device shows.
blood pressure
heart rate
Meaningful
Things that change how a life goes, not only a number.
cognitive function
A registered study says what someone planned to measure. It does not say what they found. A number moving is not the same as a life going better. The two are shown apart here.
Felt, but not shown to help. A person notices a change. No study showed it leads anywhere good.
Measured, but not felt. A number moves. The person notices nothing. Both can be true.
Measured, but not shown to matter. A number moves in the good direction. Nobody showed that lives went better.
Matters, but takes years. The result that counts may take longer than anyone would keep watching.
Names that fit none of the three (3)
reinforcing effects
responses to affective touch
safety measures
These are harms, study-process measures, or names the rules did not recognise. They are shown rather than dropped.
What it would be like to take◇Read from sources, not yet reviewed
How long anything takes
Nine different lengths of time that get confused with each other. None of them is worked out from another.
Before anything is noticed.RNAWiki does not store this separately, and never works it out from another figure on this page.
Before a test result moves.RNAWiki does not store this separately, and never works it out from another figure on this page.
Before performance moves.RNAWiki does not store this separately, and never works it out from another figure on this page.
How long the result was watched.No finished study window is recorded for a study that tested this substance.
How long people took it.How long people actually took it is not stored. The study window is not the same thing.
How long people were followed.Follow-up length is not stored separately. It is never read off the study window, which would be a different thing.
How fast the body clears it. 4 to 5 hours hours
Read from the label, which states: “The biological half-life has been reported in the range of 4 to 5 hours.”
How long effects linger.RNAWiki does not store this separately, and never works it out from another figure on this page.
Beyond the studies. Nothing is recorded about the long term.
The longest finished study sets the edge of what anyone measured.
A study window is not how long people took it, and neither is how long they were followed. Where RNAWiki holds only one of the three, it shows one.
What is missing or unclear◇Read from sources, not yet reviewed
Were people like you studied?
RNAWiki cannot tell whether a study fits you. It can show who was in it, and where the result stops carrying.
Who was studied
People similar to this profile were included.
Medically: children over six with ADHD, in practice rarely, because there are many alternatives and the prescribing burden is high. Otherwise: a large population using illicitly manufactured methamphetamine, which is now high-purity and cheap in North America.
Who is missing from the studies
Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What the label states about particular groups
On pediatric, the label states: “The safety and effectiveness of methamphetamine hydrochloride tablets have not been established in pediatric patients younger than 6 years old.”
US prescribing information · 90c02ac6-e5e2-4c97-8c68-81e4e389a195 · read 2026-08-30
On older people, the label states: “Clinical studies of methamphetamine hydrochloride tablets did not include sufficient numbers of subjects age 65 years and over to determine whether elderly subjects respond differently from younger subjects.”
US prescribing information · 90c02ac6-e5e2-4c97-8c68-81e4e389a195 · read 2026-08-30
On people who are pregnant, the label states: “Exposure Registry There is a pregnancy exposure registry that monitors pregnancy outcomes in women exposed to ADHD medications, including methamphetamine hydrochloride tablets, during pregnancy.”
US prescribing information · 90c02ac6-e5e2-4c97-8c68-81e4e389a195 · read 2026-08-30
On people who are breastfeeding, the label states: “Risk Summary Based on limited case reports in the published literature, methamphetamine and its active metabolite, amphetamine, are present in human milk.”
US prescribing information · 90c02ac6-e5e2-4c97-8c68-81e4e389a195 · read 2026-08-30
Where the result stopped carrying
Every candidate pharmacotherapy for methamphetamine use disorder, with the largest rigorous effect being a 13.6% response rate that has not produced an approval
Functional recovery after abstinence was incomplete even where dopamine transporter binding recovered
This is a scope explorer, not a diagnosis engine.
It shows who was studied so you can see whether people similar to you were included.
RNAWiki cannot tell whether a study fits you. It can show who was in it.
What it would be like to take◇Read from sources, not yet reviewed
Why it might seem to do nothing
A real effect and a noticed effect are different things. These are the recorded reasons the two come apart.
It was studied for a different goal
The studies measured something else entirely.
On this record: Some registered studies measured things that match no goal on this page.
It was studied in different people
The people in the studies were not much like the reader.
On this record: Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
The evidence may simply be wrong
Small early studies often do not hold up.
On this record: RNAWiki has not yet published a reviewed conclusion for this use.
Other reasons RNAWiki checked and found nothing for (10)
A different form was studied
The studied form is not the form on the shelf. Nothing in this record points to this reason.
There was nothing to correct
Where a level is already normal, topping it up may change nothing. Nothing in this record points to this reason.
Something else had to happen too
In the studies it was paired with training, a diet or another treatment. Nothing in this record points to this reason.
The change is too small to feel
A real change can still sit below what a person notices. Nothing in this record points to this reason.
Day-to-day swing hides it
Sleep, food, stress and time of day move most numbers more than this would. Nothing in this record points to this reason.
Not enough time yet
The studies ran longer than the person has waited. Nothing in this record points to this reason.
It was not taken as studied
Missed days change the result, and studies count them. Nothing in this record points to this reason.
Something else changed at the same time
Two changes at once cannot be told apart afterwards. Nothing in this record points to this reason.
The product may not be what it says
Contents of a sold product are not always what the label states. Nothing in this record points to this reason.
No recorded reason
RNAWiki has nothing stored that would explain it. Nothing in this record points to this reason.
None of these is a reason to take more. Taking more is not a step this page ever suggests.
What it would be like to take◇Read from sources, not yet reviewed
What taking it involves
The recorded facts about getting hold of it and using it. Nothing here is a suggestion about what you should do.
How it is supplied
Prescription only
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
Read from the recorded approval status.
No source is stored against this line.
Form and route
Oral tablet, once daily, in the approved product
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form and route recorded on this substance.
No source is stored against this line.
Who oversees it
Professional supervision is normally required. A regulator classifies this substance in a way that restricts how it is supplied.
❝ Quoted from a source
Where this came from
Copied from a source RNAWiki stored, with the source named.
Suppression classes recorded: S2, S6.
No source is stored against this line.
What is in the pack
The prescription product is a plain oral tablet with a long half-life, giving once-daily dosing and a slow rise in brain concentration.
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
Recorded notes on how this is sold. The rest of the recorded wording: That pharmacokinetic profile is the difference between the medicine and the street drug: the reinforcing effect of a releaser depends on how fast dopamine efflux rises, and an oral tablet raises it slowly.
No source is stored against this line.
Where it is registered
Regulatory records are listed in the technical disclosure at the foot of this page.
# Counted from records
Where this came from
A count of rows RNAWiki holds. It describes our records, not your body.
Register entries are stored per jurisdiction and shown with their dates.
No source is stored against this line.
Why people stop
Not recorded.
∅ Nothing recorded
Where this came from
RNAWiki holds nothing here and says so rather than guessing.
No record of why people stopped taking it is stored for this substance.
No source is stored against this line.
What it would be like to take◇Read from sources, not yet reviewed
What can go wrong
Sorted by where each line came from. A regulator's label and a report somebody sent in are not the same kind of fact.
·Worth asking a clinician aboutWritten into the record from the studies named on this page
The label states in capitals that methamphetamine has a high potential for abuse, should be prescribed or dispensed sparingly, and that misuse may cause sudden death and serious cardiovascular adverse events. It records extensive abuse, tolerance, extreme psychological dependence and severe social disability; abrupt cessation after prolonged high dosage produces extreme fatigue and mental depression with sleep EEG changes; chronic intoxication produces severe dermatoses, marked insomnia, irritability and a psychosis clinically indistinguishable from schizophrenia. Growth suppression has been reported with long-term stimulant use in children. Cardiovascular effects include tachycardia, hypertension and, with chronic heavy use, cardiomyopathy.
Nobody counted how many people took this and were fine, so this cannot be turned into a rate.
These are reports people sent to a regulator. They do not show the medicine caused the reaction.
Nobody counted how many people took the medicine and reported nothing.
The same event can be reported more than once, and many reports are incomplete.
News coverage, lawsuits and new warnings change how often people report.
A count is not a rate and not a risk.
Metamfetamine appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 180 reaction mentions were counted. One report can name several reactions.
The recorded terms (10)
cardiomyopathy — 65 reaction mentions
drug abuser — 39 reaction mentions
drug abuse — 15 reaction mentions
loss of consciousness — 11 reaction mentions
heart rate increased — 9 reaction mentions
substance abuse — 9 reaction mentions
acute coronary syndrome — 8 reaction mentions
blood pressure increased — 8 reaction mentions
drug withdrawal syndrome neonatal — 8 reaction mentions
pulmonary hypertension — 8 reaction mentions
open-targets-adr · recorded 2026-06-24 · a recorded source, not a stored snapshot
Over a long time. No completed tested study window is recorded, so long-term effects are not established by the registry record.
Groups the studies covered thinly. Which groups were under-represented in the studies has not been recorded for this substance. Pregnancy, breastfeeding, children, older adults, and people with liver or kidney conditions are commonly excluded from trials; nothing here says whether they were.
What is missing or unclear◇Read from sources, not yet reviewed
Does the exact form matter?
Evidence belongs to the exact thing that was tested. A different salt, a different mixture or a different preparation is a different question.
The form that was studied
Oral tablet, once daily, in the approved product
✎ Source-linked record
Where this came from
A person wrote this into the record with the study named beside it. No reviewer has signed it off.
The form used in the studies cited on this page.
No source is stored against this line.
What is sold
A recorded note compares this form with the others that are sold. It is kept below, word for word.
§ A fixed RNAWiki sentence
Where this came from
Wording RNAWiki always uses, not a finding about this substance.
The recorded note, unchanged: That pharmacokinetic profile is the difference between the medicine and the street drug: the reinforcing effect of a releaser depends on how fast dopamine efflux rises, and an oral tablet raises it slowly.
No source is stored against this line.
What is recorded as being sold
5 products list this as an active ingredient in the United States drug directory. 5 of them contain it and nothing else.
FDA National Drug Code directory · 75907-094 · read 2026-08-29
They are sold as powder and tablet, taken oral.
FDA National Drug Code directory · 75907-094 · read 2026-08-29
The regulator's established pharmacologic class for it is amphetamine anorectic [epc], amphetamines [cs] and appetite suppression [pe].
FDA National Drug Code directory · 75907-094 · read 2026-08-29
3 published labels name it as an active ingredient. 3 of them describe this substance alone, which is where its own label text on this page comes from.
US prescribing information · f31f580f-1f08-4a0f-b078-0b9e3308f712 · read 2026-08-29
Those labels are classed as human prescription drug.
US prescribing information · f31f580f-1f08-4a0f-b078-0b9e3308f712 · read 2026-08-29
Methamphetamine Hydrochloride is oral at 3 DOSAGE FORMS AND STRENGTHS Tablets: 5 mg of methamphetamine hydrochloride as a round, white to off-white, biconvex, debossed tablet with “54” on one side and “681” on the other side., recorded as fda label in effect 2024-09-30 in the United States.
US prescribing information · 90c02ac6-e5e2-4c97-8c68-81e4e389a195 · read 2026-08-30
Recorded price in US: 5.0978 USD per one unit as the pricing file counts it — a tablet, capsule, patch or single item, across 3 priced products whose strengths and pack forms differ, as of 2026-08-26, paid by retail pharmacies buying the product, as surveyed by the Centers for Medicare & Medicaid Services. It is not a list price, an insurance price, or what anyone pays at a counter..
Recorded source · 2026-08-26 · read 2026-08-28
Evidence carries across two names for one substance. It does not carry across a salt, a mirror form or a mixture.
What it would be like to take◇Read from sources, not yet reviewed
What you could measure
This one is decided with a clinician, so this section holds questions to ask rather than a plan to run.
Self-experiment planning is not offered for a prescription or clinician-supervised medicine. The questions below are for a clinician or pharmacist.
Questions worth asking
Which of the trials of Metamfetamine studied people like me?
What was measured, and for how long?
Was the result a laboratory value or a health outcome?
What would we watch for, and when would we stop?
Tracking can show whether something changed for you. It cannot show what caused it.
RNAWiki records evidence. It does not say whether this substance is right for you.
What is missing or unclear◇Read from sources, not yet reviewed
Claims that go past the evidence
Things said about this substance that sound reasonable, and the exact step that is missing between the evidence and the claim.
✗Goes past the evidence
That neurotoxicity documented in heavy smoked or injected use describes the risk of therapeutic oral dosing, or vice versa
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That reduced PET transporter binding demonstrates neuron death — it demonstrates reduced transporter availability, and the two are not separable by this method
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
✗Goes past the evidence
That a positive amphetamine-class urine screen identifies dextromethamphetamine, when the over-the-counter decongestant enantiomer gives the same result
Why it sounds right. It follows from something real on this page: a body step, an animal result or a related finding.
The missing step. Nobody measured this in people for this use, or the study that did measure it did not show it.
What would change this
A study in people, for this exact use, measuring this exact thing, that a reviewer signs off.
RNAWiki has not yet published a reviewed conclusion for this use.
What is missing or unclear◇Read from sources, not yet reviewed
What nobody knows yet
Open questions, each with why it is open and what would close it.
How much did people take in the studies?
The sources RNAWiki checked hold nothing for this field.
Why it matters. A result belongs to an amount. Without the amount the result floats free.
What would answer it
A stored source that records it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing populations
Which groups were under-represented in the studies has not been recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing long-term data
No completed tested study window is recorded.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
No reviewed conclusion
RNAWiki has not yet published a reviewed conclusion for this use.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Missing interaction studies
No interaction was found in the registers checked. Not finding one is not the same as showing there is none.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Formulation uncertainty
Several salts, forms or products of Metamfetamine are recorded. Results from one form may not transfer to another.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
Mechanism not reviewed
No reviewed mechanism story exists for this substance.
Why it matters. Recorded by the evidence model as a gap on this record.
What would answer it
A study that measures it, and a reviewer to sign it off.
Last checked 2026-09-04. Searched: The sources listed in the receipts at the foot of this page.
What happened in people◇Read from sources, not yet reviewed
Check any of this yourself
Every line above traced back to the study it came from. This is the technical layer, and the vocabulary changes here.
Every line above can be traced to the study named beside it. Follow the link and read it.
Approved for children in 1943, and the label warns that misuse may cause sudden death
In plain words
The same drug is a prescription treatment for childhood ADHD and carries a warning in capital letters that misusing it can kill you suddenly.
What was measured
Labelled indication and labelled abuse warning for the same approved product
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Desoxyn was originally approved on 31 December 1943 under NDA 005378 and the product remains marketed, with generic methamphetamine hydrochloride tablets from several manufacturers. The current label indicates it for attention deficit disorder with hyperactivity in children over 6 as part of a total treatment programme, and as a short-term adjunct in exogenous obesity. The label opens with a boxed statement that methamphetamine has a high potential for abuse, that it should be prescribed or dispensed sparingly, and that misuse may cause sudden death and serious cardiovascular adverse events; it records that the drug has been extensively abused and that tolerance, extreme psychological dependence and severe social disability have occurred. Both statements are true of the same molecule and neither is rhetorical. The variable is the exposure pattern, not the substance.
Source
Methamphetamine hydrochloride tablets prescribing information (Mayne Pharma, DailyMed) and Drugs@FDA NDA 005378, original approval 31 December 1943
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
verified
Review state
Written into the record, not signed off as a reviewed claim
Dopamine transporter loss in heavy users partially recovers after long abstinence
In plain words
Brain imaging showed methamphetamine users had substantially fewer dopamine transporters than controls. After more than a year abstinent, the deficit had partly reversed.
What was measured
Striatal dopamine transporter availability by PET in abusers versus controls, and after >1 year of abstinence
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Volkow and colleagues imaged dopamine transporter availability with PET in methamphetamine abusers and controls. In the first study, DAT reduction was associated with psychomotor impairment and with memory deficits, establishing that the imaging finding tracked function rather than being an isolated marker. In the follow-up, abusers re-scanned after protracted abstinence of more than a year showed significant recovery of DAT binding, while performance on motor and memory tasks did not fully normalise. The two results together are the substance of the neurotoxicity claim and its limit: the transporter loss is real and measurable, part of it reverses with time, and the functional recovery is incomplete over the periods studied. The imaging measures transporter protein availability, not neuron death, and the distinction is not resolvable by PET.
Written into the record, not signed off as a reviewed claim
ADAPT-2: naltrexone plus bupropion worked, and it worked in 13.6% of people
In plain words
The best result any medicine has produced for methamphetamine use disorder: about 14 people in 100 responded, against 2.5 in 100 on placebo.
What was measured
Weighted response rate — at least 3 of 4 methamphetamine-negative urines at end of stage
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Multisite, double-blind, two-stage, placebo-controlled trial with a sequential parallel comparison design in adults with moderate or severe methamphetamine use disorder, testing extended-release injectable naltrexone plus oral extended-release bupropion. 403 participants entered stage 1 and 225 stage 2. Response was defined as at least three methamphetamine-negative urine samples out of four at the end of a stage. Stage 1: 18 of 109 (16.5%) on naltrexone-bupropion versus 10 of 294 (3.4%) on placebo. Stage 2: 13 of 114 (11.4%) versus 2 of 111 (1.8%). Weighted average across both stages was 13.6% versus 2.5%, treatment effect 11.1 percentage points, Wald z=4.53, P<0.001. Adverse events included gastrointestinal disorders, tremor, malaise, hyperhidrosis and anorexia; serious adverse events in 8 of 223 (3.6%) receiving the combination. The authors' own summary is the honest one: the response was low, and it was higher than placebo.
Written into the record, not signed off as a reviewed claim
The mirror image of the same molecule is sold over the counter
In plain words
Levmetamfetamine, the left-handed version of methamphetamine, is the active ingredient in some over-the-counter nasal inhalers.
What was measured
Enantiomeric identity as the determinant of pharmacology and legal status for one formula
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
Methamphetamine has one stereocentre and therefore two enantiomers with identical molecular formula (C10H15N) and mass (149.23). The (S)-(+) enantiomer, dextromethamphetamine, is the Schedule II prescription drug and the psychoactive one. The (R)-(-) enantiomer, levmetamfetamine (PubChem CID 36604), is a peripherally acting sympathomimetic used as a topical nasal decongestant in over-the-counter inhalers in the United States. Both give a positive result on a standard amphetamine-class urine immunoassay; only a chiral separation distinguishes them. This is a routine analytical fact with non-routine consequences, and it is the reason forensic laboratories perform chiral confirmation before reporting a methamphetamine positive in a context with legal consequences.
Source
PubChem CID 10836 (dextromethamphetamine) and CID 36604 (levmetamfetamine); standard forensic chiral confirmation practice
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
verified
Review state
Written into the record, not signed off as a reviewed claim
Nothing else has worked, and the winner works in one patient in seven
In plain words
Methamphetamine use disorder has no approved medication. The best-performing combination in a rigorous trial helped about one in seven people.
What was measured
Number of approved pharmacotherapies for methamphetamine use disorder as of this audit: zero
Effect estimate
No reviewed effect estimate exists for this record.
Limits
This entry records a failure.
From the source
Despite a large trial programme spanning bupropion alone, mirtazapine, modafinil, methylphenidate substitution, naltrexone alone and topiramate, no pharmacotherapy is approved for methamphetamine use disorder. ADAPT-2's naltrexone-bupropion combination produced the largest and most rigorously demonstrated effect to date, and it was a weighted response rate of 13.6% against 2.5%. The reason is structural rather than a failure of effort: substitution therapy works for opioids because a slower-onset agonist occupies the same receptor, and there is no equivalent for a releaser whose reinforcing effect depends on the magnitude and rate of dopamine efflux. Contingency management remains the intervention with the most consistent randomised evidence, and it is a behavioural programme rather than a drug.
Written into the record, not signed off as a reviewed claim
The prescription dose and the street exposure are not comparable, and the label is written for one of them
In plain words
Everything documented about Desoxyn comes from small oral doses once a day. Everything documented about methamphetamine neurotoxicity comes from repeated large smoked or injected doses.
What was measured
That dopamine terminal toxicity documented in heavy high-dose users describes the risk of therapeutic oral dosing, or that the therapeutic safety record describes the risk of heavy use
Effect estimate
No reviewed effect estimate exists for this record.
Limits
See the technical detail.
From the source
The safety data supporting the Desoxyn label were generated with oral tablets at therapeutic doses in a monitored population. The imaging studies showing dopamine transporter reduction studied heavy users with a route and frequency that produce far higher peak brain concentrations. Neither dataset speaks to the other. The specific mechanism proposed for the terminal toxicity — dopamine displaced from vesicles into the cytoplasm, where it auto-oxidises to quinones and reactive oxygen species — is concentration- and duration-dependent, so it is not a property that transfers unchanged across a hundred-fold difference in exposure. What cannot be said is that the prescription product is therefore safe at any dose, or that the street exposure describes what the tablet does. Both are inferences the available data do not support.
Source
Methamphetamine hydrochloride tablets prescribing information versus Volkow ND et al., J Neurosci 2001;21:9414-9418
Role in the trial
Not matched to a registered study
Identity check
no open identity hold
Audit mark
caution
Review state
Written into the record, not signed off as a reviewed claim
How many documents were read
3 documents were read for this substance.
RNAWiki source record
3 of them state the same halfLife, and they agree.
RNAWiki source record
Checks this page had to pass
✓ Passed
Identity resolved
no open identity hold
✓ Passed
No unresolved merge across substance families
no quarantine open
✓ Passed
Every public sentence names a source
The opening statement carries the origin: Written into the record, not signed off.
✗ Not passed
Trial roles classified for highlighted evidence
No registered study is classified as testing this substance.
✓ Passed
No internal keys in reader text
enforced by the copy-contract test over the rendered page
✓ Passed
Safety mode resolved
Suppression classes recorded: S2, S6.
✓ Passed
Canonical metadata present
slug and display name present
What is missing or unclear◇Read from sources, not yet reviewed
How this medicine reached us
Kept near the foot of the page. A historical event moves up only when it changes something about this substance today.
What the approval register records
7 approved applications cover products containing this substance. The earliest was NDA005378, approved 19431231 to AJENAT PHARMS.
This order is fixed in code and does not count clicks or time on the page.
What is not here
3 questions this page could not answer
These sections were prepared and left out because there was nothing to put in them. They are listed rather than hidden, so the gaps in this record are visible.
What it may clash with — found nothing in the sources checked.
Other ways to the same goal — found nothing in the sources checked.
What changed on this page — found nothing in the sources checked.
The record as stored
The full record, for auditing
Everything above is built from what is below. This layer keeps the technical vocabulary, record identifiers and every stored row, so a reader who wants to check the page can.
The older medicine-wide conclusion held in this record
Written for a clinical reader, and about the medicine as a whole rather than about one indication, population and set of trials. RNAWiki does not treat it as a programme conclusion and no reviewer has signed it off in that form. It is here word for word because it is what the record holds.
A Schedule II drug approved for childhood ADHD since 1943 whose label warns that misuse may cause sudden death, and whose dopamine transporter losses in heavy users partially recover after more than a year of abstinence.
Recorded evidence blocks (10)
Q2
What did Metamfetamine's largest trial (138 people) and its longest (4.9 years) measure?
138 people in Metamfetamine's largest registered study, 4.9 years in its longest registered window, measuring Number of Methamphetamine Doses Self-Administered. ClinicalTrials.gov · 2026-09-01
6 early phase1, 5 phase1, 3 phase4, 2 phase2, 1 na; NCT01967381; 2018-09; no ageing endpoint recorded. Last human test completed 2024, NCT04642820.
Interpretation These counts include studies where Metamfetamine was a comparison treatment, a background treatment or an exposure in an observational study, and the longest window may be a planned end date. Trial roles have not yet been classified for this record.
Show the evidence
early phase1
6
phase1
5
phase4
3
phase2
2
na
1
Last recorded human testNCT04642820
2024-06-01
recorded 2026-09-01 · last checked 2026-09-04
Q3
Metamfetamine was tested only in human — what did it show?
Chnage in the severity of OCD symptoms as measured by the Yale-Brown Obsessive Compulsive Scale (YBOCS); Number of participants with CS-1103-related adverse events (AEs) assessed by physical examinations; latest 2030-05
Show the evidence
Trial
NCT05783817
"MDMA-Assisted CBT for OCD (MDMA-CBT4OCD Study)"; n 40; "Chnage in the severity of OCD symptoms as measured by the Yale-Brown Obsessive Compulsive Scale (YBOCS)"; 2026-12-01
NCT06721494
"A Single-Dose Study to Evaluate Safety and Efficacy of CS-1103 in Participants Receiving a Single Dose of Methamphetamine"; n 40; "Number of participants with CS-1103-related adverse events (AEs) assessed by physical examinations"; 2026-09-11
NCT06989853
"Methamphetamine and Troriluzole"; n 40; "Reinforcing Effects of Methamphetamine"; 2029-02-28
NCT07584369
"Short-term Effects of Methamphetamine on Residual Latent HIV Disease Study"; n 20; "HIV Transcription (Cell-associated HIV RNA) in Peripheral Blood"; 2030-05
recorded 2026-09-01 · last checked 2026-09-04
Q8
Which 4 trials of Metamfetamine posted no result?
Posted no result
4 of 4 completed trials
Registrations
NCT01967381, NCT05003076, NCT05379959 and NCT04614584
Completion dates
oldest 2018-09; newest 2024-05-31
Show the evidence
Trial
NCT01967381
2018-09
NCT05003076
2023-04-01
NCT05379959
2023-10-24
NCT04614584
2024-05-31
Q9
At the median, Metamfetamine's trials enrolled 36 people — anything larger?
Median enrolment
36
Largest enrolment
138
Registered trials counted
17
Q10
What do 180 spontaneous reports say about Metamfetamine — and not say?
These are reports people sent to a regulator. They do not show the medicine caused the reaction. Nobody counted how many people took the medicine and reported nothing. The same event can be reported more than once, and many reports are incomplete. News coverage, lawsuits and new warnings change how often people report. A count is not a rate and not a risk.
Metamfetamine appears in spontaneous reports to regulators. Across the 10 most-reported reaction terms, 180 reaction mentions were counted: cardiomyopathy 65; drug abuser 39; drug abuse 15; loss of consciousness 11. open-targets-adr · CHEMBL1200952 · 2026-06-24
Show the evidence
cardiomyopathy
65
drug abuser
39
drug abuse
15
loss of consciousness
11
heart rate increased
9
substance abuse
9
4 more recorded rows
acute coronary syndrome
8
blood pressure increased
8
drug withdrawal syndrome neonatal
8
pulmonary hypertension
8
recorded 2026-06-24 · last checked 2026-09-04
Q11
Metamfetamine and CYP2D6: shared by which compounds?
CYP2D6 appear in Metamfetamine's recorded interaction sentences, 2 in all. openfda-label+europepmc · 2025-11-07
Interpretation drug_interactions
Show the evidence
CYP2D6
drug_interactions
CYP2D6 Inhibitors Clinical Impact: Concomitant use of methamphetamine hydrochloride tablets, USP and CYP2D6 inhibitors may increase the exposure of methamphetamine hydrochloride tablets, USP compared to the use of the drug alone, and increase the risk of serotonin syndrome.
drug_interactions
If serotonin syndrome occurs, discontinue methamphetamine hydrochloride tablets, USP and the CYP2D6 inhibitor [see Warnings and Precautions 5.8].
recorded 2025-11-07 · last checked 2026-09-04
Where it is registeredIdentifiers, relations and other names
ClinicalTrials.gov — US Government work · Europe PMC — metadata only, under the recorded legal gate · Open Targets 26.06 — CC0 · derived from this page's own recorded fields; no external licence · mixed register set; per-register licences in docs/specs/corpus-20k-sources.md · openFDA / DailyMed — US Government work
✗ required summary fields resolved: 5 required field(s) not terminal: Why people use it, Best-supported result, Most important common problem, Biggest unanswered question, Human evidence
✓ public claims reviewed: 0 reviewed claim(s); drafts are never rendered
✓ source coverage passed: 7 source rows
✓ no critical contamination: no quarantine open
✓ canonical metadata passed: slug and display name present
✓ no raw internal fields: enforced by the copy-contract test over the rendered page
This is a record of evidence. It is not medical advice, and it does not say this substance suits you. Nothing here says any substance on RNAWiki is appropriate for a child.