title: Modafinil for the treatment of cocaine dependence.
abstract: OBJECTIVE
  Modafinil was tested for efficacy in facilitating abstinence in cocaine-dependent patients, compared to placebo.
  
  
  METHODS
  This was a double-blind placebo-controlled study, with 12 weeks of treatment and a 4-week follow-up. Six outpatient substance abuse treatment clinics participated in the study. There were 210 treatment-seekers randomized, having a diagnosis of cocaine dependence; 72 participants were randomized to placebo, 69 to modafinil 200mg, and 69 to modafinil 400mg, taken once daily on awakening. Participants came to the clinic three times per week for assessments and urine drug screens, and had one hour of individual psychotherapy weekly. The primary outcome measure was the weekly percentage of cocaine non-use days.
  
  
  RESULTS
  The GEE regression analysis showed that for the total sample, there was no significant difference between either modafinil group and placebo in the change in average weekly percent of cocaine non-use days over the 12-week treatment period (p>0.79). However, two secondary outcomes showed significant effects by modafinil 200mg: the maximum number of consecutive non-use days for cocaine (p=0.02), and a reduction in craving (p=0.04). Also, a post hoc analysis showed a significant effect of modafinil that increased the weekly percentage of non-use days in the subgroup of those cocaine patients who did not have a history of alcohol dependence (p<0.02).
  
  
  CONCLUSIONS
  These data suggest that modafinil, in combination with individual behavioral therapy, was effective for increasing cocaine non-use days in participants without co-morbid alcohol dependence, and in reducing cocaine craving.
authors: Division of Pharmacotherapies and Medical Consequences of Drug Abuse, National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20892-9551, USA. aa135m@nih.gov
authors: Ann L
authors: AL
authors: Anderson
authors: Malcolm S
authors: MS
authors: Reid
authors: Shou-Hua
authors: SH
authors: Li
authors: Tyson
authors: T
authors: Holmes
authors: Lynn
authors: L
authors: Shemanski
authors: April
authors: A
authors: Slee
authors: Edwina V
authors: EV
authors: Smith
authors: Roberta
authors: R
authors: Kahn
authors: Nora
authors: N
authors: Chiang
authors: Frank
authors: F
authors: Vocci
authors: Domenic
authors: D
authors: Ciraulo
authors: Charles
authors: C
authors: Dackis
authors: John D
authors: JD
authors: Roache
authors: Ihsan M
authors: IM
authors: Salloum
authors: Eugene
authors: E
authors: Somoza
authors: Harold C
authors: HC
authors: Urschel
authors: Ahmed M
authors: AM
authors: Elkashef
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000523:psychology; D001559:Benzhydryl Compounds / Q000009:adverse effects / Q000627:therapeutic use*; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use*; D019970:Cocaine-Related Disorders / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D000077408:Modafinil; D010349:Patient Compliance; D011569:Psychiatric Status Rating Scales; D011613:Psychotherapy; D012307:Risk Factors; D012959:Socioeconomic Factors; D016896:Treatment Outcome; D016482:Urinalysis
chemical_list: D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D000077408:Modafinil