A randomized controlled trial of fluoxetine in the treatment of cocaine dependence among methadone-maintained patients.
BACKGROUND
Cocaine abuse and dependence continue to be widespread. Currently, there are no pharmacotherapies shown to be effective in the treatment of cocaine dependence.


METHODS
A 33-week outpatient clinical trial of fluoxetine (60 mg/day, po) for cocaine dependence that incorporated abstinence-contingent voucher incentives was conducted. Participants (N = 145) were both cocaine and opioid dependent and treated with methadone. A stratified randomization procedure assigned subjects to one of four conditions: fluoxetine plus voucher incentives (FV), placebo plus voucher incentives (PV), fluoxetine without vouchers (F), and placebo without vouchers (P). Dosing of fluoxetine/placebo was double blind. Primary outcomes were treatment retention and cocaine use based on thrice-weekly urine testing.


RESULTS
The PV group had the longest treatment retention (M = 165 days) and lowest probability of cocaine use. The adjusted predicted probabilities of cocaine use were 65% in the P group, 60% in the F group, 56% in the FV group, and 31% in the PV group.


CONCLUSIONS
Fluoxetine was not efficacious in reducing cocaine use in patients dually dependent on cocaine and opioids.
Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati College of Medicine, Cincinnati, OH 45220, USA. erinwinstanley@me.com
Erin L
EL
Winstanley
George E
GE
Bigelow
Kenneth
K
Silverman
Rolley E
RE
Johnson
Eric C
EC
Strain
D000328:Adult; D019970:Cocaine-Related Disorders / Q000150:complications / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D005473:Fluoxetine / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D009042:Motivation; D009294:Narcotics / Q000627:therapeutic use; D058850:Opiate Substitution Treatment / Q000379:methods; D009293:Opioid-Related Disorders / Q000150:complications / Q000534:rehabilitation*; D017367:Selective Serotonin Reuptake Inhibitors / Q000627:therapeutic use*; D015813:Substance Abuse Detection; D013997:Time Factors; D014040:Token Economy; D016896:Treatment Outcome
D005473:Fluoxetine; D008691:Methadone; D009294:Narcotics; D017367:Selective Serotonin Reuptake Inhibitors
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