Quetiapine for the treatment of cocaine dependence: an open-label trial.
The monaminergic properties of second generation antipsychotics are prompting research on their use to treat cocaine dependence, with inconclusive results to date. In preliminary reports, the atypical antipsychotic quetiapine has shown promise for the treatment of substance abuse disorders. The primary objective of the current study was to assess the efficacy of quetiapine in reducing cocaine cravings and use in nonpsychotic subjects with cocaine dependence over 6 weeks of open-label treatment. Twenty-two cocaine-dependent, nonpsychotic men were initiated to open-label treatment with quetiapine (300-600 mg/d). The primary outcome measure was weekly self-report of cocaine cravings as assessed with the Brief Substance Craving Scale. Cocaine use was captured with a self-report Timeline Follow-back calendar, administered every 2 weeks. Side effect monitoring was conducted weekly, and movement disorders were assessed every 2 weeks. Intent-to-treat regression analyses (n = 22) indicated that the Brief Substance Craving Scale total score decreased significantly overtime (P < 0.001). Self-reports also suggested decreased cocaine use. There was no treatment-related increase in movement disorders, and most side effects were mild. However, all subjects did experience sedation, and several subjects dropped out because of it. What is more, weight increased significantly over time (P < 0.001). Open-label quetiapine treatment reduced cravings and improved some aspects of cocaine dependence in nonpsychotic individuals. Additional research is needed to confirm the current findings and to further delineate the role quetiapine may play in the treatment of cocaine use disorders.
Kennedy
Annette
A
Mental Illness Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA. Annette.Kennedy@va.gov
Wood
Amanda Ernst
AE
Saxon
Andrew J
AJ
Malte
Carol
C
Harvey
Megan
M
Jurik
Jennifer
J
Kilzieh
Nael
N
Lofgreen
Cassin
C
Tapp
Andre
A
D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D019970:Cocaine-Related Disorders / Q000188:drug therapy* / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D003987:Dibenzothiazepines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D000069348:Quetiapine Fumarate; D012720:Severity of Illness Index; D013575:Syncope / Q000139:chemically induced; D013607:Tablets; D013997:Time Factors; D016896:Treatment Outcome; D015430:Weight Gain / Q000187:drug effects; D014987:Xerostomia / Q000139:chemically induced
D014150:Antipsychotic Agents; D003987:Dibenzothiazepines; D013607:Tablets; D000069348:Quetiapine Fumarate