RESUMO
This Phase I trial evaluated the interaction between modafinil steady-state and cocaine. Twelve non-treatment seeking, cocaine dependent volunteers received four sets of randomized blinded infusions of saline, 20 mg IV cocaine, and 40 mg IV cocaine. Modafinil was given open label at 0 mg, 400 mg, or 800 mg. Modafinil combined with IV cocaine did not result in any significant hemodynamic interactions. Modafinil significantly dampened scores on Visual Analog Scale measures as compared to baseline cocaine conditions. No significant alterations in labs occurred. Further outpatient trials of modafinil appear to be warranted.
Assuntos
Compostos Benzidrílicos/uso terapêutico , Transtornos Relacionados ao Uso de Cocaína/tratamento farmacológico , Fármacos Neuroprotetores/uso terapêutico , Compostos Benzidrílicos/administração & dosagem , Pressão Sanguínea/efeitos dos fármacos , Cocaína/administração & dosagem , Interações Medicamentosas , Humanos , Infusões Intravenosas , Modafinila , Segurança , Resultado do TratamentoRESUMO
Preclinical models of cocaine dependence have shown favorable reductions in cocaine use using dihydropyridine calcium channel antagonists. This is one of the first reports testing the efficacy of the long-acting calcium channel antagonist, amlodipine, for the treatment of cocaine dependence. This was a 12-week, double-blind, randomized, placebo-controlled, parallel patient group trial of amlodipine vs. placebo for the treatment of cocaine dependence. One hundred and sixteen subjects participated in a 12-week medication trial in which 60 subjects received medication and 56 received placebo. Subjects in both groups received up to 12 standard manual-driven cognitive behavioral therapy sessions. Overall, drop-out rate for both groups was high, with only about 20% of subjects completing all 12 weeks of treatment. Both groups showed comparable levels of medication compliance and therapy attendance. In the end, amlodipine was no more effective than placebo in reducing craving or measured levels of cocaine use.
Assuntos
Anlodipino/uso terapêutico , Bloqueadores dos Canais de Cálcio/uso terapêutico , Transtornos Relacionados ao Uso de Cocaína/reabilitação , Terapia Cognitivo-Comportamental , Adulto , Assistência Ambulatorial , Anlodipino/efeitos adversos , Bloqueadores dos Canais de Cálcio/efeitos adversos , Cocaína/análogos & derivados , Cocaína/urina , Transtornos Relacionados ao Uso de Cocaína/epidemiologia , Terapia Combinada , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Cooperação do Paciente/psicologia , Cooperação do Paciente/estatística & dados numéricos , Pacientes Desistentes do Tratamento/psicologia , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Detecção do Abuso de Substâncias/estatística & dados numéricos , Resultado do TratamentoRESUMO
Although benzodiazepines are the standard of care in the treatment of alcohol withdrawal, several studies have suggested that anticonvulsants may be equally effective at alleviating alcohol withdrawal symptoms and may pose less of a risk of causing rebound of symptoms which could contribute to relapse. This report compares treatment outcomes for patients (N=13) treated for alcohol withdrawal with either the anticonvulsant tiagabine or the benzodiazepines oxazepam and lorazepam. The Clinical Institute Withdrawal Assessment for Alcohol-revised (CIWA-Ar) was utilized to gauge alcohol withdrawal symptoms over the course of the study. When possible, follow-up data was obtained on alcohol use post-treatment. Both benzodiazepines and tiagabine appeared to reduce CIWA-Ar scores at about the same magnitude. There was a trend for tiagabine patients to have less post-detoxification drinking (Fisher exact test, p = 0.12). The reduction in alcohol withdrawal symptoms and decreased tendency to relapse observed in patients treated with the anticonvulsant tiagabine suggests that a double-blind, placebo controlled trial may be warranted.
