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Antidepressants for cocaine dependence.

M S Lima1, A A Reisser, B G Soares

  • 1Department of Mental Health, Universidade Federal de Pelotas, Av. Duque de Caxias, 250, Pelotas, Rio Grande do Sul, Brazil, 96100. mslima@nutecnet.com.br

The Cochrane Database of Systematic Reviews
|November 1, 2001
PubMed
Summary
This summary is machine-generated.

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This review found no evidence that antidepressants effectively treat cocaine dependence. While some antidepressants showed trends, none were significant, suggesting psychotherapy may be more beneficial for patient retention.

Area of Science:

  • Neuroscience
  • Psychiatry
  • Pharmacology

Background:

  • Cocaine dependence is a significant public health issue.
  • Chronic cocaine abuse down-regulates monoamine systems, potentially causing depression and craving.
  • Antidepressants may alleviate withdrawal symptoms by augmenting monoamine levels.

Purpose of the Study:

  • To systematically review randomized controlled trials (RCTs) on antidepressant use for cocaine dependence.

Main Methods:

  • Searched multiple databases (Cochrane, MEDLINE, EMBASE, etc.) up to 2000.
  • Included RCTs focusing on antidepressants for cocaine dependence, including those with co-occurring opiate dependence.
  • Extracted data independently, estimating Relative Risks and weighted mean difference.

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Main Results:

  • 18 studies with 1177 participants were reviewed.
  • No antidepressant significantly reduced positive cocaine metabolite tests.
  • Desipramine showed a non-significant trend; imipramine showed a non-significant improvement in self-reported response. Fluoxetine suggested reduced dropout rates.

Conclusions:

  • Currently, no evidence supports the clinical use of antidepressants for cocaine dependence.
  • High dropout rates in this population suggest incorporating supportive psychotherapy is crucial for treatment retention.