title: WITHDRAWN: Dopamine agonists for cocaine dependence.
abstract: BACKGROUND
  Cocaine dependence is a common and serious condition, which has become a substantial public health problem. There is a wide and well documented range of consequences associated to chronic use of cocaine, such as medical, psychological and social problems.. Therapeutic management of the cocaine addicts includes an initial period of abstinence from the drug. During this phase the subjects may experience, besides the intense craving for cocaine, symptoms such as depression, fatigue, irritability, anorexia, and sleep disturbances. It was demonstrated that the acute use of cocaine may enhance dopamine transmission and chronically it decreases dopamine concentrations in the brain. Pharmacological treatment that affects dopamine could theoretically reduce these symptoms and contribute to a more successful therapeutic approach.
  
  
  OBJECTIVE
  To evaluate the efficacy and acceptability of dopamine agonists for treating cocaine dependence.
  
  
  METHODS
  Electronic searches of Cochrane Library, EMBASE, MEDLINE, PsycLIT, Biological Abstracts and LILACS; reference searching; personal communication; conference abstracts; unpublished trials from pharmaceutical industry; book chapters on treatment of cocaine dependence, was performed for the primary version of this review in 2001. Another search of the electronic databases was done in December of 2002 for this update. The specialised register of trials of the Cochrane Group on Drugs and Alcohol was searched until February 2003.
  
  
  METHODS
  The inclusion criteria for all randomised controlled trials were that they should focus on the use of dopamine agonists on the treatment of cocaine dependence.
  
  
  METHODS
  The reviewers extracted the data independently and Relative Risks, weighted mean difference and number needed to treat were estimated. The reviewers assumed that people who died or dropped out had no improvement and tested the sensitivity of the final results to this assumption.
  
  
  RESULTS
  Seventeen studies were included, with 1224 participants randomised. Amantadine, bromocriptine, and pergolide were the drugs evaluated. The main outcomes evaluated were positive urine sample for cocaine metabolites, for efficacy, and retention in treatment, as an acceptability measure. There were no significant differences between interventions, and in trials where participants had primary cocaine dependence or had additional diagnosis of opioid dependence and/or were in methadone maintenance treatment.
  
  
  CONCLUSIONS
  Current evidence does not support the clinical use of dopamine agonists in the treatment of cocaine dependence. Given the high rate of dropouts in this population, clinicians may consider adding other supportive measures aiming to keep patients in treatment.
authors.affiliation: Brazilian Cochrane Centre, Universidade Federal de São Paulo, Rua Pedro de Toledo 598, São Paulo, SP, Brazil, 04039-001.
authors.forename: Bernardo
authors.initials: B
authors.lastname: Soares
authors.forename: Anelise Arl
authors.initials: AA
authors.lastname: Lima Reisser
authors.forename: Michael
authors.initials: M
authors.lastname: Farrell
authors.forename: Mauricio
authors.initials: M
authors.lastname: Silva de Lima
mesh_terms: D000547:Amantadine / Q000627:therapeutic use; D001971:Bromocriptine / Q000627:therapeutic use; D019970:Cocaine-Related Disorders / Q000188:drug therapy*; D018491:Dopamine Agonists / Q000627:therapeutic use*; D006801:Humans; D016032:Randomized Controlled Trials as Topic
chemical_list: D018491:Dopamine Agonists; D001971:Bromocriptine; D000547:Amantadine