Human Pharmacology Unit, Hospital del Mar Medical Research Institute-IMIM, UCICEC-CAIBER, Parc de Salut MAR, 08003 Barcelona, Spain; Universitat Autònoma de Barcelona (Department of Pharmacology, Therapeutics and Toxicology and Department of Psychiatry), 08193 Bellaterra (Cerdanyola del Vallès), Spain.
A systematic review and meta-analysis to evaluate the efficacy of antipsychotic drugs in subjects with cocaine dependence is presented. Twelve randomized, double-blind, placebo-controlled clinical trials involving 681 patients were included. Five outcome measures were evaluated: number of dropouts, cocaine use assessed by means of urine benzoylecgonine tests, self-reported cocaine use, craving and Addiction Severity Index. On average, 48% of the enrolled participants were lost to follow-up. In comparison to placebo, antipsychotics did not significantly reduce cocaine use (WMD=0.01, 95%CI=-0.12 to 0.13) or improve retention in treatment (RR 0.91, 95%CI=0.82-1.02). Risperidone reduced slightly dropouts in comparison to placebo (RR=0.87; 95%CI=0.79-0.97). To date there is insufficient evidence to justify the use of antipsychotic drugs for cocaine dependence.
Copyright © 2012. Published by Elsevier Inc.
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