Pilot randomized double blind placebo-controlled study of dexamphetamine for cocaine dependence

Authors: Shearer, James¹; Wodak, Alex²; van Beek, Ingrid³; Mattick, Richard P.¹; Lewis, John⁴

Source: Addiction, Volume 98, Number 8, August 2003 , pp. 1137-1141(5)

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Abstract:

Aims

To establish the feasibility of conducting a placebo-controlled clinical trial of dexamphetamine replacement therapy for cocaine dependence and to obtain preliminary data. Design

Double-blind randomized placebo-controlled trial. Participants

Thirty cocaine-dependent injecting drug users. Intervention

Subjects were assigned randomly to receive 60 mg/day dexamphetamine (n = 16) or placebo (n = 14) for 14 weeks. Measurements

Immunoassay and mass spectrometric techniques were used to identify cocaine metabolites in urine. Subjects were screened using the Composite International Diagnostic Interview and DSM-IV. The Opiate Treatment Index, Brief Symptom Inventory, Severity of Dependence Scale and visual analogue craving scales were used to collect pre- and post-self-report data. Findings

Treatment retention was equivalent between groups; however, outcomes favoured the treatment group with no improvements observed in the placebo control group. The proportion of cocaine-positive urine samples detected in the treatment group declined from 94% to 56% compared to no change in the placebo group (79% positive). While the improvements were not significant between groups, within-group analysis revealed that the treatment group reduced self-reported cocaine use (P = 0.02), reduced criminal activity (P = 0.04), reduced cravings (P < 0.01) and reduced severity of cocaine dependence (P < 0.01) with no within-group improvements found in the placebo group. Conclusions

A definitive evaluation of the utility of dexamphetamine in the management of cocaine dependence is feasible and warranted.

Keywords: Cocaine dependence, dexamphetamine, randomized con

Document Type: Research article

DOI: http://dx.doi.org/10.1046/j.1360-0443.2003.00447.x

Affiliations: 1: National Drug and Alcohol Research Centre, University of New South Wales, 2: St Vincent's Hospital, 3: Kirketon Road Centre, Sydney Hospital 4: and Pacific Laboratory Medicine Services, Sydney, Australia4

Publication date: 2003-08-01

Pilot randomized double blind placebo-controlled study of dexamphetamine for cocaine dependence

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