Antipsychotic medications for cocaine dependence

摘要: Background Cocaine dependence is a public health problem characterised by recidivism and host of medical psychosocial complications. Cocaine remains disorder for which no pharmacological treatment proven efficacy exists. Objectives To evaluate the acceptability antipsychotic medications cocaine dependence. Search methods This review an update previous Cochrane published in 2007. We searched up to 15 July 2015 Drugs Alcohol Group Specialised Register (searched CRSLive); Library (including Central Controlled Trials (CENTRAL); Database Abstracts Reviews Effects (DARE)); PubMed; EMBASE; CINAHL Web Science. All searches included non-English language literature. Selection criteria All randomised controlled trials clinical with focus on use any medication dependence. Data collection analysis We used standard methodological procedures expected Cochrane. Main results We 14 studies (719 participants). The drugs studied were risperidone, olanzapine, quetiapine, lamotrigine, aripiprazol, haloperidol reserpine. Comparing versus placebo, we found that antipsychotics reduced dropout: eight studies, 397 participants, risk ratio (RR) 0.75 (95% confidence interval (CI) 0.57 0.97), moderate quality evidence. significant differences other primary outcomes considered: number participants using during treatment, two 91 participants: RR 1.02 CI 0.65 1.62); continuous abstinence, three 139 1.30 0.73 2.32); side effects, six 291 1.01 0.93 1.10); craving, four 240 0.13 (-1.08 1.35). For all these comparisons rated evidence as low. Comparisons single drug placebo or another are conducted few small sample sizes, limiting reliability results. Among comparisons, only quetiapine seemed outperform reducing use, measured grams per week: mean difference (MD) -0.54 -0.92 -0.16), US dollars spent MD -53.80 -97.85 -9.75), craving: -1.23 -2.19 -0.27), but results came from one study 60 participants. The major limitations high attrition bias (40% studies) low reporting, mainly selection bias, performance detection being at unclear 75% 80% studies. Furthermore, most did not report important such prevented possibility including them statistical synthesis. Authors' conclusions At present, there supporting dependence, although come trials, sizes