Daily monitored cardiovascular effects of carbamazepine in chronic crack cocaine users

During a 20-day, double-blind, placebo-controlled, fixed-dose outpatient trial of carbamazepine (either 200 mg or 400 mg) for potential anticocaine treatment effects in volunteers who were unmotivated for treatment and who lacked any external coercion for cocaine abstinence, we monitored cardiovascular effects in 30 subjects on a daily basis. All individual cardiovascular measures obtained were within clinically normal limits. Corrected QT interval under carbamazepine was shorter than under placebo condition, although both were in the normal range. Systolic pressure was elevated by 2.1 mm Hg. No differences in pulse rate were found. With carbamazepine and concurrent ad lib cocaine use, heart rate was significantly, although not clinically, elevated (mean increase = 2.3 beats/minute). The analysis of these approximately 600 observations indicates that carbamazepine in cocaine users, alone and in combination with ad lib street crack use, causes no clinically significant cardiovascular effects.