title: Aripiprazole and ropinirole treatment for cocaine dependence: evidence from a pilot study.
abstract: BACKGROUND
  Currently, there is no specific pharmacological therapy with established efficacy for the treatment of cocaine dependence. The aim of this study was to determine the safety, tolerability and the effects of aripiprazole and ropinirole in patients with cocaine dependence.
  
  
  METHODS
  This randomized clinical trial of 12-week duration was carried out on 28 consecutive patients with cocaine dependence presenting for treatment. The diagnostic assessment was performed using ICD-9-CM criteria and Mini International Neuropsychiatric Interview. The Clinical Global Impression Scale, a Visual Analogue Scale to assess craving and a self-report questionnaire on the use of cocaine were administered at baseline and then weekly throughout the study. Urinalyses were carried out three times per weeks to search for benzoylecgonine.
  
  
  RESULTS
  Of the 28 study participants, 14 completed the protocol. Treatment discontinuation was unrelated with side effects. One patient required a dosage reduction of ropinirole because of sleepiness and one patient assigned to aripiprazole who reported moderate akathysia had the dosage reduced to 5 mg/day. Routine blood works did not show significant changes from baseline and the overall proportion of positive urinalyses for benzoylecgnonine did not differ significantly between treatments. Using linear mixed-effect models a significant decrease in craving was found in the overall sample (p<0.001). The mean number of cocaine administrations exhibited a faster decrease with aripiprazole compared with ropinirole (p=0.009).
  
  
  CONCLUSIONS
  Our pilot study indicates that cocaine craving decreases with both aripiprazole and ropinirole treatment but aripiprazole is more efficacious in reducing cocaine use.
authors.affiliation: Department of Medicine and Public Health, University of Bologna, Via San Giacomo 12, 40100 Bologna, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Meini
authors.forename: M
authors.initials: M
authors.lastname: Moncini
authors.forename: D
authors.initials: D
authors.lastname: Cecconi
authors.forename: V
authors.initials: V
authors.lastname: Cellesi
authors.forename: L
authors.initials: L
authors.lastname: Biasci
authors.forename: G
authors.initials: G
authors.lastname: Simoni
authors.forename: M
authors.initials: M
authors.lastname: Ameglio
authors.forename: M
authors.initials: M
authors.lastname: Pellegrini
authors.forename: R N
authors.initials: RN
authors.lastname: Forgione
authors.forename: P
authors.initials: P
authors.lastname: Rucci
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D000068180:Aripiprazole; D003042:Cocaine / Q000031:analogs & derivatives / Q000652:urine; D019970:Cocaine-Related Disorders / Q000188:drug therapy*; D018491:Dopamine Agonists / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D007211:Indoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D010879:Piperazines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D011569:Psychiatric Status Rating Scales; D015363:Quinolones / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014150:Antipsychotic Agents; D018491:Dopamine Agonists; D007211:Indoles; D010879:Piperazines; D015363:Quinolones; C046649:ropinirole; C005618:benzoylecgonine; D000068180:Aripiprazole; D003042:Cocaine