Dopamine agonists for cocaine dependence

摘要: BACKGROUND Cocaine is a major drug of abuse. dependence common and serious condition, which has become nowadays substantial public health problem. There wide well documented range consequences associated to chronic use this drug, such as medical, psychological social problems, including the spread infectious diseases (e.g. AIDS, hepatitis tuberculosis), crime, violence neonatal exposure. Therapeutic management cocaine addicts includes an initial period abstinence from drug. During phase subjects may experience, besides intense craving for cocaine, symptoms depression, fatigue, irritability, anorexia, sleep disturbances. It was demonstrated that acute enhance dopamine transmission chronically it decreases concentrations in brain. Pharmacological treatment affects could theoretically reduce these contribute more successful therapeutic approach. OBJECTIVES To evaluate efficacy acceptability agonists treating dependence. SEARCH STRATEGY We searched: The Cochrane Controlled Trials Register (Cochrane Library, issue 4, 2000), MEDLINE (from 1966 - EMBASE 1980 LILACS 1982 PsycLIT 1974 Biological Abstracts (1982 2000). Reference searching; personal communication; conference abstracts; unpublished trials pharmaceutical industry; book chapters on SELECTION CRITERIA inclusion criteria all randomised controlled were they should focus patients with additional diagnosis opiate also eligible. DATA COLLECTION AND ANALYSIS reviewers extracted data independently Relative Risks, weighted mean difference number needed treat estimated. assumed people who died or dropped out had no improvement tested sensitivity final results assumption. MAIN RESULTS Twelve studies included, 587 participants randomised. Amantadine Bromocriptine compared placebo most trials. In two amantadine directly bromocriptine, while desipramine, antidepressant three. main outcome presented positive urine sample metabolites, significant differences between interventions. When retention assessed measure, found similar rate remaining both active drugs. where primary opioid and/or methadone maintenance treatment. REVIEWER'S CONCLUSIONS Current evidence does not support clinical Given high dropouts population, clinicians consider adding psychotherapeutic supportive measures aiming keep