Pharmacotherapy for Cocaine-Abusing Methadone-Maintained Patients Using Amantadine or Desipramine

doi:10.1001/archpsyc.1992.01820110058009

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Vol. 49 No. 11, November 1992

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Pharmacotherapy for Cocaine-Abusing Methadone-Maintained Patients Using Amantadine or Desipramine

Thomas R. Kosten, MD; Charles M. Morgan, MD; Jean Falcione, MA; Richard S. Schottenfeld, MD

Arch Gen Psychiatry. 1992;49(11):894-898.

Abstract

• In a double-blind, placebo-controlled 12-week randomizedclinical trial, we compared amantadine hydrochloride (300 mg/d;n=33), desipramine hydrochloride (150 mg/d; n=30), and placebo(n=31) in the treatment of cocaineabusing methadone-maintainedpatients. Treatment retention and medication compliance wereexcellent, with more than 75% of the patients completing thefull 12-week trial. Although reported cocaine abuse was significantlylower in the medicated groups compared with the placebo groupat week 4, this difference became nonsignificant at week 8,and no difference was found in cocaine-free urine samples. Futurestudies of amantadine and desipramine treatment in these patientsshould consider alternatives to methadone hydrochloride, suchas buprenorphine hydrochloride, and the selection of more homogeneouspatient subgroups, such as depressed cocaine abusers.

Author Affiliations

From the Substance Abuse Treatment Unit, Department of Psychiatry, Yale University School of Medicine, New Haven, Conn.

Footnotes

Accepted for publication January 9, 1992.

Reprint requests to the Substance Abuse Treatment Unit, 27 SylvanAve, New Haven, CT 06519 (Dr Kosten).

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