Aspirin or amiloride for cerebral perfusion defects in cocaine dependence.
Cocaine dependent (CD) patients have regional cerebral blood flow (rCBF) deficits that may be related to occlusion of blood vessels by vasoconstriction and abnormal platelet aggregation. This study determined whether aspirin, which reverses platelet aggregation, or amiloride, a vasodilator, significantly reversed this rCBF hypoperfusion. This 1-month randomized trial compared clusters of voxels with significant hypoperfusion in recently abstinent CD patients after aspirin (325 mg daily), amiloride (10 mg daily) or placebo treatment. Forty-nine primary CD patients and 18 non-drug abusing controls were compared using single photon emission computed tomography (SPECT) neuroimaging with 99mTc-hexamethyl-propyleneamine-oxime and statistical parametric mapping (SPM). Platelet aggregation to adenosine diphosphate (ADP) was examined after treatment to determine whether rCBF improvement was related to decreased platelet aggregation. Following treatment, areas of hypoperfusion were improved with amiloride, unchanged with aspirin, and worsened with placebo in comparison to baseline levels. Platelet aggregation after ADP showed no significant change during the month, but reduced rCBF significantly improved after 1-month treatment with amiloride compared with placebo and cocaine abstinence alone.
Kosten
Thomas R
TR
Department of Psychiatry, 151D, Yale University School of Medicine, VA Connecticut Healthcare System, 950 Campbell Avenue Bldg., Room 41, West Haven, CT 06516, USA. thomas.kosten@yale.edu
Gottschalk
P Christopher
PC
Tucker
Karen
K
Rinder
Christine S
CS
Dey
Holly M
HM
Rinder
Henry M
HM
D000328:Adult; D000584:Amiloride / Q000494:pharmacology / Q000627:therapeutic use*; D001241:Aspirin / Q000494:pharmacology / Q000627:therapeutic use*; D002560:Cerebrovascular Circulation / Q000187:drug effects* / Q000502:physiology; D016009:Chi-Square Distribution; D019970:Cocaine-Related Disorders / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods
D000584:Amiloride; D001241:Aspirin