[Mirtazapine in the treatment of cocaine-dependence in patients with methadone].
OBJECTIVE
To evaluate efficacy, interactions and adherence to treatment in cocaine-dependent patients (according to DSM- IV criteria). Its impact on reducing/quitting both cocaine and especially benzodiazepines (BZP) is of a great concern.


METHODS
Thirty-one patients with an average age of 35 years, mean methadone dose of 155 mg/day and an average staying time on MMP of 21 months started treatment with MTZ, 60 mg/day as a single dose. One patient had to take 90 mg/day. One patient was excluded because of poor performance in the methadone maintenance program (MMP). In the pre-treatment evaluation, 22% of the patients did not use BZP and 40% used only cocaine. Sixty three percent used cocaine in higher dose than 0.5 g/day. (Range: 0.5-2 g). Abusive alcohol drinkers or patients with severe organic or psychiatric impairment were discarded.


RESULTS
MTZ is well tolerated and its adverse effects are welcome in this kind of patients. Adherence to treatment was quite good for these reasons and because MTZ has a short latency time. No dose adjustments or interactions with other prescriptions (e.g., HAART), were shown. Hamilton-17, GCI, stress and craving scales were employed. Drug use was monitored with enzyme immune assay. At the end of the study, seven patients (23%) managed to quit cocaine. No BZP use was reported in 20 patients (80%).


CONCLUSIONS
MTZ has shown good results in ceasing street BZP abuse, as well as reducing cocaine abuse though in the minor abusers. Treatment adherence was quite good and no evidence of interactions with drug-related treatments was reported.
Zueco Pérez
P L
PL
Centro de Atención Integral a Drogodependientes (CAID) San Blas. Madrid. Spain. Pedro.zueco@eresmas.net
D000328:Adult; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use*; D019970:Cocaine-Related Disorders / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008803:Mianserin / Q000031:analogs & derivatives / Q000627:therapeutic use*; D008875:Middle Aged; D000078785:Mirtazapine; D009294:Narcotics / Q000627:therapeutic use*
D000929:Antidepressive Agents, Tricyclic; D009294:Narcotics; D008803:Mianserin; D000078785:Mirtazapine; D008691:Methadone