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Modafinil Does Not Reduce Cocaine Use in Methadone-Maintained Individuals.
Elise E DeVito1, James Poling1,2, Theresa Babuscio1
1Department of Psychiatry, Yale School of Medicine, New Haven, CT.
Drug and Alcohol Dependence Reports
|October 31, 2022
Summary
Modafinil did not prove effective for treating cocaine use disorder (CUD) in individuals also dependent on opioids. The study found no significant difference between modafinil and placebo in reducing substance use or improving cognition.
Area of Science:
- Neuroscience
- Psychiatry
- Pharmacology
Background:
- Cocaine use disorder (CUD) lacks approved pharmacological treatments.
- Modafinil, a cognitive enhancer, has shown preliminary promise for CUD.
- Efficacy of modafinil in dual cocaine and opioid dependence is unexamined.
Purpose of the Study:
- To evaluate modafinil's efficacy, with contingency management (CM), for cocaine and opioid use reduction.
- To assess modafinil's impact on cognitive function in dually dependent individuals.
- To investigate modafinil's effectiveness in methadone-stabilized patients with CUD.
Main Methods:
- A 17-week, double-blind, randomized controlled trial.
- Four arms: modafinil + CM, modafinil + yoked-control (YC), placebo + CM, placebo + YC.
- All participants received cognitive behavioral therapy (CBT) and methadone.
Main Results:
- Modafinil was well-tolerated with few adverse effects.
- Modafinil did not outperform placebo in reducing cocaine or opioid use.
- No significant improvements in cognitive performance were observed with modafinil.
Conclusions:
- Modafinil is not effective for treating CUD in methadone-stabilized individuals with dual dependence.
- Findings do not support modafinil as a treatment for CUD in this population.
- Robust trial design indicates lack of modafinil efficacy in this context.
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