Neurohormonal and behavioral response to methylphenidate in cocaine abstinence

We investigated prolactin (PRL) and growth hormone (GH) secretion during acute and late abstinence following methylphenidate (MP) administration. Ten male patients who were undergoing acute cocaine abstinence and nine control subjects were randomly assigned into one of two possible sequences of MP and placebo, with each experimental condition occurring on two successive days. This procedure was repeated after 7 days for the patients. Baseline measures were analyzed by analysis of variance (ANOVA) with post hoc tests. Measures of MP challenge were analyzed by analysis of covariance (ANCOVA) with baseline as the covariate. Acute abstinence was compared with control values and then to late abstinence. Plasma levels of PRL, GH, and MP were measured along with a measure of clinical symptoms. Patients had higher basal PRL concentrations during acute abstinence compared with controls, and patients showed no difference when compared to themselves after 7 days (late abstinence). Provocation with MP yielded exaggerated PRL and GH responses in patients during acute abstinence compared with control values, and ANCOVA also revealed a significant increase in PRL response during late abstinence compared with acute abstinence. GH was a less sensitive indicator than PRL. Craving was exacerbated by MP during both acute and late abstinence and was possibly increased at late abstinence. This indicates that the perturbation in dopamine regulation persists and may be increased as clinical recovery occurs for most subjective symptoms. Blood pressure changes were variable and interpretation was uncertain.