Aripiprazole in schizophrenia with cocaine dependence: a pilot study

Area of Science:

• Psychiatry
• Neuroscience
• Addiction Medicine

Background:

• Schizophrenia (SCHZ) severity increases with comorbid cocaine dependence (CD) and alcohol abuse.
• No current medications effectively treat both SCHZ and CD simultaneously.
• Aripiprazole's dopamine-modulating properties suggest potential for reducing cocaine craving in SCHZ + CD patients.

Purpose of the Study:

• To investigate the efficacy of aripiprazole in alleviating cocaine and alcohol cravings in patients with schizophrenia and comorbid cocaine dependence.
• To assess the impact of aripiprazole on psychosis symptoms and actual cocaine use in this patient population.

Main Methods:

• Prospective, 8-week, open-label trial.
• 10 male patients with SCHZ + CD received aripiprazole (max 15 mg/d) as their sole neuroleptic.
• Psychosis (BPRS), craving (BSCS), and urine tests for cocaine were assessed.

Main Results:

• 60% of subjects completed the trial.
• Significant reduction in positive urine tests for cocaine (P < 0.001).
• Significant decline in cocaine craving (P = 0.026) and alcohol craving (P = 0.006).
• Declining psychosis scores correlated with reduced cocaine (r = 0.87) and alcohol craving (r = 0.88).

Conclusions:

• Aripiprazole shows potential in reducing both craving and use of cocaine in patients with comorbid schizophrenia and cocaine dependence.
• The findings support the need for further investigation through double-blind, randomized controlled trials in this severely ill patient group.