The pharmacotherapy of relapse prevention using anticonvulsants

This review of anticonvulsants for relapse prevention in substance abusers focuses on a series of clinical trials among cocaine abusers. Based on a preclinical rationale linking kindling with drug craving, several studies by Halikas et al. found reductions in cocaine use and craving among "compliant" subjects with blood levels above 4 mu/ml. Three independent randomized trials found no difference from placebo in cocaine use, although treatment retention may be higher during the first 6 weeks, and alcohol use might be less at follow-up after medication discontinuation.