期刊
NEUROPSYCHOPHARMACOLOGY
卷 30, 期 1, 页码 205-211出版社
SPRINGERNATURE
DOI: 10.1038/sj.npp.1300600
关键词
modafinil; cocaine; glutamate; pharmacotherapy; abstinence; addiction
资金
- NATIONAL INSTITUTE ON DRUG ABUSE [P50DA012756, P60DA005186] Funding Source: NIH RePORTER
Despite years of active research, there are still no approved medications for the treatment of cocaine dependence. Modafinil is a glutamate-enhancing agent that blunts cocaine euphoria under controlled conditions, and the current study assessed whether modafinil would improve clinical outcome in cocaine-dependent patients receiving standardized psychosocial treatment. This was a randomized, double-blind, placebo-controlled trial conducted at a university outpatient center (from 2002 to 2003) on a consecutive sample of 62 (predominantly African American) cocaine-dependent patients (aged 25-63) free of significant medical and psychiatric conditions. After screening, eligible patients were randomized to a single morning dose of modafinil (400 mg), or matching placebo tablets, for 8 weeks while receiving manual-guided, twice-weekly cognitive behavioral therapy. The primary efficacy measure was cocaine abstinence based on urine benzoylecgonine levels. Secondary measures were craving, cocaine withdrawal, retention, and adverse events. Modafinil-treated patients provided significantly more BE-negative urine samples (p = 0.03) over the 8-week trial when compared to placebos, and were more likely to achieve a protracted period (greater than or equal to3 weeks) of cocaine abstinence (p = 0.05). There were no serious adverse events, and none of the patients failed to complete the study as a result of adverse events. This study provides preliminary evidence, which should be confirmed by a larger study, that modafinil improves clinical outcome when combined with psychosocial treatment for cocaine dependence.
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