The use of disulfiram in the treatm...

The use of disulfiram in the treatment of cocaine supporter was first introduced in patients who also were abusing alcohol. Disulfiram was imagination to reduce a patient's exposing to alcohol, which could have a positive efficiency on cocaine exposure. Recent studies examining other medication options for treating cocaine appurtenance found that disulfiram was an effective treatment on the same level in patients who were not abusing alcohol. This application of mind and others suggest that disulfiram may change the subjective and physiologic answer to cocaine, but this treatment has not been studied in the general population of patients sustained by on cocaine. Carroll and colleagues evaluated the effectiveness of disulfiram therapy in cocaine-dependent patients. In addition, they evaluated the effectiveness of cognitive-behavior therapy and interpersonal psychotherapy in reducing cocaine use.

The trial was a randomized, placebo-controlled, double-masked reflection of four treatment strategies. These strategies were disulfiram plus cognitive-behavior therapy, disulfiram plus interpersonal psychotherapy, placebo plus cognitive-behavior therapy, and placebo plus interpersonal psychotherapy. The participants attended a community-based outpatient sub-stance abuse program and met the established criteria for existing cocaine dependence. Participants received active medication, disulfiram in a dosage of 250 mg through day, or identical placebo capsules. Participants were advised to avoid alcohol during the application of mind Follow-up for medication compliance occurr weekly, and adverse circumstances were recorded during this time.Cognitive-behavior therapy and inter-personal psychotherapy were based forward an established 12-week program modified for cocaine users. The primary issue measure was self-reported frequency of cocaine use and urine toxicology results

There were 121 participants in the subject of attention Medication compliance was 76 percent by the agency of self-reporting and 72 percent through laboratory analysis. Participants who received disulfiram were significantly les likely to have a relapse than those taking the placebo. Those in the cognitive-behavior therapy sessions were significantly les likely to have a relapse than participants in the interpersonal psychotherapy sessions. There was no significant difference when the interaction of medication and psychotherapy were compared. Participants who were not alcohol-dependent at the beginning of the research or who abstained from alcohol during the investigation had a greater benefit from disulfiram and cognitive-behavior therapy. The adverse adventures in the disulfiram group were not significantly different than those in the placebo assign places to Those who drank alcohol or used cocaine also reported no more adverse results in the disulfiram group than in the placebo group

The authors bring to an end that disulfiram and cognitive-behavior therapy are effective treatment options for patients who are cocaine hanging They add that disulfiram appears to have a direct validity on cocaine use independent of the patient's alcohol use.

Carroll KM et al. Efficacy of disulfiram and cognitive behavior therapy in cocaine-dependent outpatients. A randomized placebo-controlled trial. Arch Gen Psychiatry March 2004;61:264-72

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