title: A double-blind placebo-controlled trial of N-acetylcysteine in the treatment of cocaine dependence.
abstract: BACKGROUND
  There remains no FDA approved medication for the treatment of cocaine dependence. Preclinical studies and early pilot clinical investigations have suggested that N-acetylcysteine (NAC) may be useful in the treatment of the disorder.
  
  
  OBJECTIVE
  The present report assessed the efficacy of NAC in the treatment of cocaine dependence.
  
  
  METHODS
  Cocaine-dependent volunteers (n = 111) were randomized to receive daily doses of 1,200 mg of NAC, 2,400 mg of NAC, or placebo. Participants were followed for 8 weeks (up to three visits weekly). At each of these visits, urine samples were collected, along with self-reports of cocaine use. Urine samples were assessed for quantitative levels of benzoylecognine (ie, cocaine metabolite).
  
  
  RESULTS
  Overall, the primary results for the clinical trial were negative. However, when considering only subjects who entered the trial having already achieved abstinence, results favored the 2,400 mg NAC group relative to placebo, with the 2,400 mg group having longer times to relapse and lower craving ratings.
  
  
  CONCLUSIONS
  While the present trial failed to demonstrate that NAC reduces cocaine use in cocaine-dependent individuals actively using, there was some evidence it prevented return to cocaine use in individuals who had already achieved abstinence from cocaine.
  
  
  CONCLUSIONS
  N-acetylcysteine may be useful as a relapse prevention agent in abstinent cocaine-dependent individuals.
authors: Ralph H. Johnson VAMC, Charleston, South Carolina, USA.
authors: Steven D
authors: SD
authors: LaRowe
authors: Peter W
authors: PW
authors: Kalivas
authors: Joyce S
authors: JS
authors: Nicholas
authors: Patrick K
authors: PK
authors: Randall
authors: Pascale N
authors: PN
authors: Mardikian
authors: Robert J
authors: RJ
authors: Malcolm
mesh_terms: D000111:Acetylcysteine / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D027182:Amino Acid Transport System y+ / Q000187:drug effects*; D019970:Cocaine-Related Disorders / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D011569:Psychiatric Status Rating Scales; D011581:Psychological Tests; D055502:Secondary Prevention; D016896:Treatment Outcome
chemical_list: D027182:Amino Acid Transport System y+; C118895:SLC7A11 protein, human; D000111:Acetylcysteine
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