Treatment of Cocaine Dependence in Methadone Maintenance Clients: A Pilot Study Comparing the Efficacy of Desipramine and Amantadine

• NCJ Number: 139936
• Journal: International Journal of the Addictions Volume: 27 Issue: 7 Dated: (1992) Pages: 849-868
• Author(s): A F Kolar; B S Brown; W W Weddington; C C Haertzen; B S Michaelson; J H Jaffe
• Date Published: 1992
• Length: 20 pages
• Publication Format: Article
• Publication Type: Research (Applied/Empirical)
• Language: English
• Country: United States of America

Annotation

This study found that amantadine and desipramine resulted in significant reductions in cocaine use, the craving for cocaine, and depression in methadone maintenance clients in Baltimore, Maryland.

Abstract

Subjects included 43 individuals who met referral criteria and underwent intake evaluation. They had used cocaine at least twice weekly for the previous 2 months. Subjects were randomly assigned to one of three treatment conditions: 12 weeks of desipramine 200 mg/day; 8 weeks of amantadine 200 mg/day, followed by 4 weeks of placebo; or 12 weeks of inactive placebo. All were required to attend weekly group counseling sessions, as well as weekly or more frequent individual counseling sessions. Psychiatric diagnoses were evaluated at intake using the Schedule for Affective Disorders and Schizophrenia-Lifetime Version. Structured questionnaires were employed to assess psychoactive substance use disorder, antisocial personality disorder, and pathological gambling disorder. Attention deficit disorder was evaluated using Utah criteria, and the level of current psychiatric symptomatology at intake was determined using the Hopkins Symptom Check List. In addition, the Beck Depression Inventory (long form) and craving scale were administered weekly. Cocaine use, cocaine craving, and depressive symptoms declined significantly for all three groups, and intergroup differences were not significant. Clients receiving desipramine were significantly more likely to remain in treatment and to be cocaine free at study completion. Six of eight subjects who received placebo correctly guessed that they were receiving placebo only; nonetheless, they reduced their cocaine use and craving. The results emphasize the importance of delivering comprehensive services to cocaine users in methadone treatment. Further evaluation of desipramine and amantadine as adjuncts in the treatment of cocaine dependence are needed. 23 references, 4 tables, and 5 figures