Biomaterial Database

Pharmacotherapy improves treatment outcome in depressed cocaine addicts. 1991

D M Ziedonis, and T R Kosten

Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut.

Depression is the most common psychiatric disorder in substance abusers, and results in a poorer prognosis and response to traditional chemical dependence and mental health treatment approaches. This article focuses on the use of pharmacotherapy in the treatment of the cocaine addict with secondary depression and provides general clinical treatment guidelines. It also reports on a study in which depressed, methadone-maintained cocaine addicts were treated in a 12-week placebo-controlled trial that compared two pharmacological agents. Patients were randomly assigned to receive placebo, amantadine (a dopamine agonist) or desipramine (a tricyclic antidepressant). The effects of pharmacotherapy were assessed on program retention, cocaine craving, cocaine usage, and depressed mood. Compared to the placebo-treated patients, it was found that the medication-treated depressed patients had a dramatic decrease in their reported cocaine usage (84% versus 17%) and cocaine craving (48% decrease versus 29% increase). Also, the medication-treated depressed patients dramatically increased the percentage of cocaine-free urines compared to the placebo-treated depressed patients who actually decreased their percentage of cocaine-free urines. A measure of depressive symptoms (Beck Depression Index score) increased 100% for the placebo-treated depressed patients, yet remained stable for the medication-treated depressed patients.

UI	MeSH Term	Description	Entries
D008297	Male		Males
D008691	Methadone	A synthetic opioid that is used as the hydrochloride. It is an opioid analgesic that is primarily a mu-opioid agonist. It has actions and uses similar to those of MORPHINE. (From Martindale, The Extra Pharmacopoeia, 30th ed, p1082-3)	Amidone,Biodone,Dolophine,Metadol,Metasedin,Methaddict,Methadone Hydrochloride,Methadose,Methex,Phenadone,Phymet,Physeptone,Pinadone,Symoron,Hydrochloride, Methadone
D003042	Cocaine	An alkaloid ester extracted from the leaves of plants including coca. It is a local anesthetic and vasoconstrictor and is clinically used for that purpose, particularly in the eye, ear, nose, and throat. It also has powerful central nervous system effects similar to the amphetamines and is a drug of abuse. Cocaine, like amphetamines, acts by multiple mechanisms on brain catecholaminergic neurons; the mechanism of its reinforcing effects is thought to involve inhibition of dopamine uptake.	Cocaine HCl,Cocaine Hydrochloride,HCl, Cocaine,Hydrochloride, Cocaine
D003866	Depressive Disorder	An affective disorder manifested by either a dysphoric mood or loss of interest or pleasure in usual activities. The mood disturbance is prominent and relatively persistent.	Depression, Endogenous,Depression, Neurotic,Depression, Unipolar,Depressive Syndrome,Melancholia,Neurosis, Depressive,Unipolar Depression,Depressions, Endogenous,Depressions, Neurotic,Depressions, Unipolar,Depressive Disorders,Depressive Neuroses,Depressive Neurosis,Depressive Syndromes,Disorder, Depressive,Disorders, Depressive,Endogenous Depression,Endogenous Depressions,Melancholias,Neuroses, Depressive,Neurotic Depression,Neurotic Depressions,Syndrome, Depressive,Syndromes, Depressive,Unipolar Depressions
D003891	Desipramine	A tricyclic dibenzazepine compound that potentiates neurotransmission. Desipramine selectively blocks reuptake of norepinephrine from the neural synapse, and also appears to impair serotonin transport. This compound also possesses minor anticholinergic activity, through its affinity to muscarinic receptors.	Desmethylimipramine,Apo-Desipramine,Demethylimipramine,Desipramine Hydrochloride,Norpramin,Novo-Desipramine,Nu-Desipramine,PMS-Desipramine,Pertofran,Pertofrane,Pertrofran,Petylyl,Ratio-Desipramine,Apo Desipramine,Hydrochloride, Desipramine,Novo Desipramine,Nu Desipramine,PMS Desipramine,Ratio Desipramine
D004311	Double-Blind Method	A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment.	Double-Masked Study,Double-Blind Study,Double-Masked Method,Double Blind Method,Double Blind Study,Double Masked Method,Double Masked Study,Double-Blind Methods,Double-Blind Studies,Double-Masked Methods,Double-Masked Studies,Method, Double-Blind,Method, Double-Masked,Methods, Double-Blind,Methods, Double-Masked,Studies, Double-Blind,Studies, Double-Masked,Study, Double-Blind,Study, Double-Masked
D005260	Female		Females
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328	Adult	A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available.	Adults
D000547	Amantadine	An antiviral that is used in the prophylactic or symptomatic treatment of influenza A. It is also used as an antiparkinsonian agent, to treat extrapyramidal reactions, and for postherpetic neuralgia. The mechanisms of its effects in movement disorders are not well understood but probably reflect an increase in synthesis and release of dopamine, with perhaps some inhibition of dopamine uptake.	1-Aminoadamantane,Adamantylamine,Adekin,Aman,Amanta,Amanta-HCI-AZU,Amanta-Sulfate-AZU,Amantadin AL,Amantadin AZU,Amantadin Stada,Amantadin-neuraxpharm,Amantadin-ratiopharm,Amantadina Juventus,Amantadina Llorente,Amantadine Hydrochloride,Amantadine Sulfate,Amixx,Cerebramed,Endantadine,Gen-Amantadine,Infecto-Flu,Infex,Mantadix,Midantan,PMS-Amantadine,Symadine,Symmetrel,Viregyt,Wiregyt,tregor,1 Aminoadamantane,AL, Amantadin,AZU, Amantadin,Amanta HCI AZU,Amanta Sulfate AZU,AmantaHCIAZU,AmantaSulfateAZU,Amantadin neuraxpharm,Amantadin ratiopharm,Amantadinneuraxpharm,Amantadinratiopharm,Gen Amantadine,GenAmantadine,Hydrochloride, Amantadine,Infecto Flu,InfectoFlu,Juventus, Amantadina,Llorente, Amantadina,PMS Amantadine,PMSAmantadine,Stada, Amantadin,Sulfate, Amantadine