A placebo controlled, double-blind study of mecamylamine treatment for cocaine dependence in patients enrolled in an opiate replacement program.

Abstract

A placebo controlled, double-blind trial of mecamylamine treatment of cocaine dependence was performed in methadone or LAAM maintained subjects who met DSM-IV criteria for cocaine dependence. After an eight-week placebo run-in screening period, 35 subjects were randomly assigned to receive either mecamylamine (6 mg/day) or placebo transdermal patches for a 16-week treatment period. Outcome measures included quantitative urine benzoylecognine (BE) levels, self-report of cocaine use, cocaine craving, global impression scores, mood, retention, and safety. Mecamylamine was well tolerated, and study retention did not differ by treatment group. Evidence for cocaine use, based on urine BE levels and cocaine abstinence rates, did not differ by treatment group. Self reported cocaine use, cocaine craving, and global impression scores showed moderate improvement in both groups, with a significantly greater reduction in cocaine craving (p < 0.05) and self-rated severity of cocaine dependence (p < 0.05) in the placebo group. This pilot study does not support the effectiveness of mecamylamine for the treatment of cocaine dependence in methadone or LAAM maintained patients.

• Authors: Malcolm S Reid, Burt Angrist, Sherryl A Baker, Siobhan O'leary, Jennifer Stone, Marion Schwartz, Deborah Leiderman, Ann Montgomery, Ahmed Elkashef, Dorota Majewska, James Robinson, John Rotrosen
• Journal: Substance abuse (Subst Abus) Vol. 26 Issue 2 Pg. 5-14 (Jun 2005) ISSN: 0889-7077 [Print] United States
• PMID: 16687365 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)

Chemical References

• Narcotics
• Nicotinic Antagonists
• benzoylecgonine
• Mecamylamine
• Cocaine
• Methadyl Acetate
• Methadone

Topics

• Administration, Cutaneous
• Cocaine (analogs & derivatives, urine)
• Cocaine-Related Disorders (rehabilitation, urine)
• Double-Blind Method
• Drug Evaluation, Preclinical
• Female
• Humans
• Male
• Mecamylamine (administration & dosage, adverse effects)
• Methadone (administration & dosage)
• Methadyl Acetate (administration & dosage)
• Narcotics (administration & dosage)
• New York City
• Nicotinic Antagonists (administration & dosage, adverse effects)
• Treatment Outcome
• Urban Population