20582
document
Efficacy screening trials of paroxetine , pentoxifylline , riluzole , pramipexole and venlafaxine in cocaine dependence . AIMS The two studies presented here were conducted to assess the efficacy of paroxetine , pentoxifylline , riluzole , venlafaxine and pramipexole as medications for the treatment of cocaine dependence . DESIGN A multi-arm , modified blinded , placebo-controlled design was used . SETTING The studies were conducted at the Boston VA Healthcare System and the Boston University School of Medicine Medication Development Research Unit ( MDRU ) . PARTICIPANTS Participants met criteria for cocaine dependence during a 2-week screening period . INTERVENTION Following random assignment to one of the treatment groups , subjects received active medication or placebo for 8 weeks in combination with cognitive behavioral counseling . In the first study the efficacy of the antidepressant paroxetine ( 20 mg daily ) , the phosphodiesterase inhibitor pentoxifylline ( 1200 mg daily ) and the glutamate release inhibitor riluzole ( 100 mg daily ) was assessed . The antidepressant venlafaxine ( 150 mg daily ) and the dopamine agonist pramipexole ( 1.5 mg daily ) were evaluated in the second study . MEASUREMENTS Urine benzoylecgonine ( BE ) concentrations , self-report of cocaine use and global impression scores served as primary outcome measures . Secondary measures included assessments of cocaine craving and psychiatric functioning . Adverse events were monitored during the treatment period . FINDINGS None of the active medications produced greater reductions in urine BE concentrations over the treatment period than did placebo . There were trends for BE levels to become reduced in the pentoxifylline group during the first 4 weeks of treatment and for Addiction Severity Index ( ASI ) drug composite scores to be lower in the pentoxyfylline group at end-point compared to the placebo group . Significant within-group reductions in reported cocaine use and craving were found for all treatment groups , but none of the active medications were superior to placebo on these measures . The accuracy of self-reported cocaine use declined over the study period . Overall , the active medications were well tolerated . CONCLUSIONS This study does not support the use of paroxetine , pentoxifylline , riluzole , venlafaxine or pramipexole for the treatment of cocaine dependence . However , these results need to be interpreted with caution because of the small size and lack of homogeneity of the experimental groups .
20583
Intervention_Pharmacological
paroxetine
20584
Intervention_Pharmacological
pentoxifylline
20585
Intervention_Pharmacological
riluzole
20586
Intervention_Pharmacological
pramipexole
20587
Intervention_Pharmacological
venlafaxine
20588
Intervention_Pharmacological
paroxetine
20589
Intervention_Pharmacological
pentoxifylline
20590
Intervention_Pharmacological
riluzole
20591
Intervention_Pharmacological
venlafaxine
20592
Intervention_Pharmacological
pramipexole
20593
Intervention_Control
placebo-controlled
20594
Intervention_Pharmacological
active medication
20595
Intervention_Control
placebo
20596
Intervention_Educational
cognitive behavioral counseling
20597
Intervention_Pharmacological
antidepressant paroxetine
20598
Intervention_Pharmacological
phosphodiesterase inhibitor pentoxifylline
20599
Intervention_Pharmacological
glutamate release inhibitor riluzole
20600
Intervention_Pharmacological
antidepressant venlafaxine
20601
Intervention_Pharmacological
dopamine agonist pramipexole
20602
Intervention_Control
placebo
20603
Intervention_Pharmacological
pentoxifylline
20604
Intervention_Pharmacological
pentoxyfylline
20605
Intervention_Control
placebo
20606
Intervention_Pharmacological
paroxetine
20607
Intervention_Pharmacological
pentoxifylline
20608
Intervention_Pharmacological
riluzole
20609
Intervention_Pharmacological
venlafaxine
20610
Intervention_Pharmacological
pramipexole
20611
Outcome_Other
Efficacy
20612
Outcome_Other
efficacy
20613
Outcome_Other
efficacy
20614
Outcome_Physical
Urine benzoylecgonine ( BE ) concentrations
20615
Outcome_Mental
self-report of cocaine use
20616
Outcome_Physical
global impression scores
20617
Outcome_Mental
assessments of cocaine craving
20618
Outcome_Mental
psychiatric functioning
20619
Outcome_Adverse-effects
Adverse events
20620
Outcome_Physical
urine BE concentrations
20621
Outcome_Physical
BE levels
20622
Outcome_Physical
Addiction Severity Index ( ASI )
20623
Outcome_Mental
cocaine use and craving
20624
Outcome_Mental
self-reported cocaine use
20625
Outcome_Other
tolerated