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Related Experiment Videos

Replacement medication for cocaine dependence: methylphenidate

J Grabowski1, J D Roache, J M Schmitz

  • 1Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Texas-Houston 77005, USA. jgrabows.ustmsimail@msi66msi.uth.tmc.edu

Journal of Clinical Psychopharmacology
|December 31, 1997
PubMed
Summary
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Methylphenidate did not significantly improve cocaine use outcomes or retention in a double-blind, placebo-controlled trial. This study suggests replacement medications may not be effective for cocaine dependence.

Area of Science:

  • Addiction Medicine
  • Psychopharmacology
  • Clinical Trials

Background:

  • Agonist medications, or replacement medications, are established treatments for opiate and nicotine dependence.
  • Their efficacy in treating cocaine dependence has not been thoroughly investigated.
  • Preliminary open-label trials of methylphenidate for cocaine dependence yielded inconclusive results.

Purpose of the Study:

  • To systematically evaluate the effectiveness of methylphenidate as a replacement medication for cocaine dependence.

Main Methods:

  • An 11-week, double-blind, placebo-controlled study involving 24 cocaine-dependent subjects.
  • Randomized assignment to receive either methylphenidate or placebo.
  • Dosing involved clinic-administered and take-home doses monitored by Medication Events Monitoring System (MEMS) bottles, alongside therapy and urine screens.

Related Experiment Videos

Main Results:

  • No significant differences were observed between the methylphenidate and placebo groups in terms of study retention (48% vs. 42%) or cocaine use outcomes (40% benzoylecgonine-positive urine screens).
  • Methylphenidate administration was associated with detectable psychoactive and side effects but did not increase cocaine craving.
  • No significant adverse effects were reported in either group.

Conclusions:

  • Methylphenidate did not demonstrate efficacy in improving retention or reducing cocaine use in this placebo-controlled trial.
  • The findings question the utility of methylphenidate as a replacement medication for cocaine dependence.
  • Further research is needed with medications possessing different pharmacological profiles to explore the replacement model for cocaine dependence.