A randomized controlled trial of fluoxetine in the treatment of cocaine dependence among methadone-maintained patients.

Abstract

BACKGROUND:

Cocaine abuse and dependence continue to be widespread. Currently, there are no pharmacotherapies shown to be effective in the treatment of cocaine dependence.

METHODS:

A 33-week outpatient clinical trial of fluoxetine (60 mg/day, po) for cocaine dependence that incorporated abstinence-contingent voucher incentives was conducted. Participants (N = 145) were both cocaine and opioid dependent and treated with methadone. A stratified randomization procedure assigned subjects to one of four conditions: fluoxetine plus voucher incentives (FV), placebo plus voucher incentives (PV), fluoxetine without vouchers (F), and placebo without vouchers (P). Dosing of fluoxetine/placebo was double blind. Primary outcomes were treatment retention and cocaine use based on thrice-weekly urine testing.

RESULTS:

The PV group had the longest treatment retention (M = 165 days) and lowest probability of cocaine use. The adjusted predicted probabilities of cocaine use were 65% in the P group, 60% in the F group, 56% in the FV group, and 31% in the PV group.

CONCLUSIONS:

Fluoxetine was not efficacious in reducing cocaine use in patients dually dependent on cocaine and opioids.

• Authors: Erin L Winstanley, George E Bigelow, Kenneth Silverman, Rolley E Johnson, Eric C Strain
• Journal: Journal of substance abuse treatment (J Subst Abuse Treat) Vol. 40 Issue 3 Pg. 255-64 (Apr 2011) ISSN: 1873-6483 [Electronic] United States
• PMID: 21266301 (Publication Type: Journal Article, Randomized Controlled Trial, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2011 Elsevier Inc. All rights reserved.

Chemical References

• Narcotics
• Serotonin Uptake Inhibitors
• Fluoxetine
• Methadone

Topics

• Adult
• Cocaine-Related Disorders (complications, drug therapy)
• Double-Blind Method
• Female
• Fluoxetine (therapeutic use)
• Humans
• Male
• Methadone (therapeutic use)
• Middle Aged
• Motivation
• Narcotics (therapeutic use)
• Opiate Substitution Treatment (methods)
• Opioid-Related Disorders (complications, rehabilitation)
• Selective Serotonin Reuptake Inhibitors (therapeutic use)
• Substance Abuse Detection
• Time Factors
• Token Economy
• Treatment Outcome