Pharmacological treatment of cocaine dependence: a systematic review.

摘要: Aims Cocaine dependence is a common and serious condition, associated with severe medical, psychological social problems, including the spread of infectious diseases. This systematic review assesses critically efficacy pharmacotherapy for treating cocaine dependence. Methods The literature search strategy included: electronic searches Cochrane Library holdings, EMBASE, MEDLINE, PsycLIT, Biological Abstracts LILACS; scans reference lists relevant articles, personal communications, conference abstracts, unpublished trials from pharmaceutical industry book chapters on treatment dependence. Randomized controlled (RCTs) focusing use antidepressants (ADs), carbamazepine (CBZ), dopamine agonists (DAs) other drugs used in were included. reviewers extracted data independently, relative risks (RR) 95% confidence interval (CI) estimated. Qualitative assessments carried out using validated checklist. Where possible, analysis was according to ‘intention-to-treat’ principles. Findings generated 45 different trials. Most studied ADs (20 studies), DAs CBZ. Data very heterogeneous, dropout rates within studies between 0 84%. A non-significant trend favoring CBZ found terms dropouts (RR 0.88; CI 0.75–1.03) results one trial suggest that fluoxetine patients are less likely drop out. main outcome reported presence metabolites urine. No significant found, regardless type drug or dose all outcomes assessed. Conclusions There no current evidence supporting clinical CBZ, antidepressants, agonists, disulfiram, mazindol, phenytoin, nimodipine, lithium NeuRecover-SA Larger randomized investigation must be considered, while taking into account these time-consuming efforts should reserved medications showing more promising evidence. Given high rate among test population, clinicians may wish consider adding psychotherapeutic supportive measures aimed at keeping programs.