Results from Australia's Landmark Tina Trial
For the first time, people seeking to stop using crystal methamphetamine may have a promising treatment option with mirtazapine. Researchers at the National Drug and Alcohol Research Centre (NDARC) at UNSW Sydney conducted the landmark Tina Trial, published in JAMA Psychiatry. This trial found that adults who took mirtazapine, a generic antidepressant, were significantly more likely to reduce their methamphetamine use compared to those given a placebo.
Professor Rebecca McKetin, the Chief Investigator, called this finding transformative. “Ours is the first clinical trial in the world to definitively confirm that once-daily mirtazapine can be used to treat methamphetamine dependence in routine clinical practice,” she said. “This is a game-changer,” she added, encouraging those struggling with methamphetamine use to seek support.
The trial enrolled 339 adults with moderate to severe methamphetamine use disorder. These participants were randomly assigned to receive either mirtazapine (30mg daily) or a placebo for a period of 12 weeks. At the beginning of the treatment, participants had been using methamphetamine on an average of 24 days out of the past 28 days.
Impact and Implications
Those in the mirtazapine group reduced their methamphetamine use by 7 days out of the past 28 days by the end of the treatment period. This was a significantly greater reduction than the 4.8-day reduction observed in the placebo group, marking an 8% decrease in the risk of methamphetamine use. In practical terms, this equates to 8 fewer days of methamphetamine use out of 100 possible use days.
The study was conducted across six outpatient clinics throughout Australia and was funded by the Medical Research Future Fund. It involved collaboration with several universities and health services, highlighting the importance of integrated efforts in addressing substance use disorders.
While there were no unexpected safety concerns, some participants who took mirtazapine reported experiencing drowsiness and weight gain. “Even small reductions in methamphetamine use can translate into meaningful improvements in health and well-being,” said Associate Professor Shalini Arunogiri, a co-author of the study and an Addiction Psychiatrist. For many participants, this trial was their first opportunity to discuss their drug use with a doctor, which provides a chance to address other healthcare needs.
Last updated: 4 April 2026, 7:55 pm
