title: Sertraline delays relapse in recently abstinent cocaine-dependent patients with depressive symptoms.
abstract: OBJECTIVE
  Whether the selective serotonin re-uptake inhibitor sertraline at 200 mg/day delays relapse in recently abstinent cocaine-dependent individuals.
  
  
  METHODS
  The study involved a 12-week, double-blind, placebo-controlled clinical trial with 2-week residential stay followed by 10-week out-patient participation.
  
  
  METHODS
  Veterans Affairs residential unit and out-patient treatment research program.
  
  
  METHODS
  Cocaine-dependent volunteers (n = 86) with depressive symptoms (Hamilton score > 15), but otherwise no major psychiatric or medical disorder or contraindication to sertraline.
  
  
  METHODS
  Participants were housed on a drug-free residential unit (weeks 1-2) and randomized to receive sertraline or placebo. Participants then participated on an out-patient basis during weeks 3-12 while continuing to receive study medication. Patients participated in a day substance abuse/day treatment program during weeks 1-3 and underwent weekly cognitive behavioral therapy during weeks 4-12. The primary outcome measure was thrice-weekly urine results and the secondary measure was Hamilton Depression scores.
  
  
  RESULTS
  Pre-hoc analyses were performed on those who participated beyond week 2. Generally, no group differences in retention or baseline characteristics occurred. Sertraline patients showed a trend towards longer time before their first cocaine-positive urine ('lapse', χ(2) = 3.67, P = 0.056), went significantly longer before having two consecutive urine samples positive for cocaine ('relapse', χ(2) = 4.03, P = 0.04) and showed significantly more days to lapse (26.1 ± 16.7 versus 13.2 ± 10.5; Z = 2.89, P = 0.004) and relapse (21.3 ± 10.8 versus 32.3 ± 14.9; Z = 2.25, P = 0.02). Depression scores decreased over time (F = 43.43, P < 0.0001), but did not differ between groups (F = 0.09, P = 0.77).
  
  
  CONCLUSIONS
  Sertraline delays time to relapse relative to placebo in cocaine-dependent patients who initially achieve at least 2 weeks of abstinence.
authors.affiliation: University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA. olivetoalison@uams.edu
authors.forename: Alison
authors.initials: A
authors.lastname: Oliveto
authors.forename: James
authors.initials: J
authors.lastname: Poling
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Mancino
authors.forename: D Keith
authors.initials: DK
authors.lastname: Williams
authors.forename: Jeff
authors.initials: J
authors.lastname: Thostenson
authors.forename: Rhonda
authors.initials: R
authors.lastname: Pruzinsky
authors.forename: Kishorchandra
authors.initials: K
authors.lastname: Gonsai
authors.forename: Mehmet
authors.initials: M
authors.lastname: Sofuoglu
authors.forename: Gerardo
authors.initials: G
authors.lastname: Gonzalez
authors.forename: Shanti
authors.initials: S
authors.lastname: Tripathi
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Kosten
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D019970:Cocaine-Related Disorders / Q000150:complications / Q000188:drug therapy* / Q000652:urine; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000150:complications / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011569:Psychiatric Status Rating Scales; D055502:Secondary Prevention; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D020280:Sertraline / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D012720:Severity of Illness Index; D013997:Time Factors; D055815:Young Adult
chemical_list: D010919:Placebos; D017367:Selective Serotonin Reuptake Inhibitors; D020280:Sertraline