title: The efficacy of olanzapine for decreasing cue-elicited craving in individuals with schizophrenia and cocaine dependence: a preliminary report.
abstract: OBJECTIVE
  Although a growing body of research suggests that atypical neuroleptic medications are efficacious in the treatment of cocaine addiction among individuals with schizophrenia, more rigorously controlled trials are needed. To extend this research, we performed a 6-week double-blind study comparing olanzapine to haloperidol with the primary objective of reducing cue-elicited cocaine craving and the secondary aims of decreasing substance use, improving psychiatric symptoms, and determining an effect size for future studies.
  
  
  METHODS
  Thirty-one subjects with cocaine dependence and schizophrenia were randomized to olanzapine or haloperidol, underwent a cue-exposure procedure, and completed psychiatric and substance abuse ratings.
  
  
  RESULTS
  Individuals in the olanzapine group who completed the study had a significant reduction on the energy subscale of the Voris Cocaine Craving Scale at study completion compared with individuals in the haloperidol group. The olanzapine-treated group also had lower, but not statistically significant, PANSS General Psychopathology Subscale scores and fewer positive urine toxicology screens compared with those in the haloperidol group.
  
  
  CONCLUSIONS
  This small, but rigorously controlled, pilot trial provides additional evidence for the use of atypical antipsychotics for the treatment of individuals with co-occurring schizophrenia and cocaine dependence. Reductions in craving were associated with medium to large effect sizes.
authors.affiliation: Department of Veterans Affairs, New Jersey Health Care System, Lyons, NJ 07939-5000, USA. David.Smelson@med.va.gov
authors.forename: David A
authors.initials: DA
authors.lastname: Smelson
authors.forename: Douglas
authors.initials: D
authors.lastname: Ziedonis
authors.forename: John
authors.initials: J
authors.lastname: Williams
authors.forename: Miklos F
authors.initials: MF
authors.lastname: Losonczy
authors.forename: Jill
authors.initials: J
authors.lastname: Williams
authors.forename: Marc L
authors.initials: ML
authors.lastname: Steinberg
authors.forename: Maureen
authors.initials: M
authors.lastname: Kaune
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use*; D016739:Behavior, Addictive / Q000188:drug therapy; D001569:Benzodiazepines / Q000627:therapeutic use; D019970:Cocaine-Related Disorders / Q000150:complications / Q000188:drug therapy*; D003463:Cues; D004311:Double-Blind Method; D006220:Haloperidol / Q000627:therapeutic use; D006801:Humans; D000077152:Olanzapine; D010865:Pilot Projects; D011569:Psychiatric Status Rating Scales; D012559:Schizophrenia / Q000150:complications / Q000188:drug therapy*
chemical_list: D014150:Antipsychotic Agents; D001569:Benzodiazepines; D006220:Haloperidol; D000077152:Olanzapine