title: A Randomized, Double-Blind, Placebo-Controlled Trial of Citicoline for Cocaine Dependence in Bipolar I Disorder.
abstract: OBJECTIVE
  Although drug dependence is common in patients with bipolar disorder, minimal data are available on the treatment of drug dependence in this patient population. The authors previously reported a decreased risk of relapse to cocaine use in a pilot study of citicoline in patients with bipolar disorder and cocaine dependence. The primary aim of the present study was to determine whether citicoline reduces cocaine use in outpatients with bipolar I disorder and current cocaine dependence and active cocaine use.
  
  
  METHODS
  A total of 130 outpatients with bipolar I disorder (depressed or mixed mood state) and cocaine dependence received citicoline or placebo add-on therapy for 12 weeks. Results of thrice-weekly urine drug screens were analyzed using a generalized linear mixed model that was fitted to the binary outcome of cocaine-positive screens at each measurement occasion for 12 weeks. Mood was assessed with the Inventory of Depressive Symptomatology-Self Report, the Hamilton Depression Rating Scale, and the Young Mania Rating Scale.
  
  
  RESULTS
  In the intent-to-treat sample (N=61 in both groups), significant treatment group and group-by-time effects were observed, whether or not missing urine screens were imputed as cocaine positive. The group effect was greatest early in the study and tended to decline with time. No between-group differences in mood symptoms or side effects were observed.
  
  
  CONCLUSIONS
  Citicoline was well tolerated for treatment of cocaine dependence in patients with bipolar disorder. Cocaine use was significantly reduced with citicoline initially, although treatment effects diminished over time, suggesting the need for augmentation strategies to optimize long-term benefit.
authors.affiliation: From the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Psychiatry and Behavioral Sciences, Center for Neurobehavioral Research on Addiction, University of Texas Health Science Center at Houston; Duke-National University of Singapore Graduate Medical School, Singapore; and VA North Texas Health Care System, Dallas.
authors.forename: E Sherwood
authors.initials: ES
authors.lastname: Brown
authors.affiliation: From the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Psychiatry and Behavioral Sciences, Center for Neurobehavioral Research on Addiction, University of Texas Health Science Center at Houston; Duke-National University of Singapore Graduate Medical School, Singapore; and VA North Texas Health Care System, Dallas.
authors.forename: Jackie Peterson
authors.initials: JP
authors.lastname: Todd
authors.affiliation: From the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Psychiatry and Behavioral Sciences, Center for Neurobehavioral Research on Addiction, University of Texas Health Science Center at Houston; Duke-National University of Singapore Graduate Medical School, Singapore; and VA North Texas Health Care System, Dallas.
authors.forename: Lisa T
authors.initials: LT
authors.lastname: Hu
authors.affiliation: From the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Psychiatry and Behavioral Sciences, Center for Neurobehavioral Research on Addiction, University of Texas Health Science Center at Houston; Duke-National University of Singapore Graduate Medical School, Singapore; and VA North Texas Health Care System, Dallas.
authors.forename: Joy M
authors.initials: JM
authors.lastname: Schmitz
authors.affiliation: From the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Psychiatry and Behavioral Sciences, Center for Neurobehavioral Research on Addiction, University of Texas Health Science Center at Houston; Duke-National University of Singapore Graduate Medical School, Singapore; and VA North Texas Health Care System, Dallas.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Carmody
authors.affiliation: From the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Psychiatry and Behavioral Sciences, Center for Neurobehavioral Research on Addiction, University of Texas Health Science Center at Houston; Duke-National University of Singapore Graduate Medical School, Singapore; and VA North Texas Health Care System, Dallas.
authors.forename: Alyson
authors.initials: A
authors.lastname: Nakamura
authors.affiliation: From the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Psychiatry and Behavioral Sciences, Center for Neurobehavioral Research on Addiction, University of Texas Health Science Center at Houston; Duke-National University of Singapore Graduate Medical School, Singapore; and VA North Texas Health Care System, Dallas.
authors.forename: Prabha
authors.initials: P
authors.lastname: Sunderajan
authors.affiliation: From the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Psychiatry and Behavioral Sciences, Center for Neurobehavioral Research on Addiction, University of Texas Health Science Center at Houston; Duke-National University of Singapore Graduate Medical School, Singapore; and VA North Texas Health Care System, Dallas.
authors.forename: A John
authors.initials: AJ
authors.lastname: Rush
authors.affiliation: From the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Psychiatry and Behavioral Sciences, Center for Neurobehavioral Research on Addiction, University of Texas Health Science Center at Houston; Duke-National University of Singapore Graduate Medical School, Singapore; and VA North Texas Health Care System, Dallas.
authors.forename: Bryon
authors.initials: B
authors.lastname: Adinoff
authors.affiliation: From the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Psychiatry and Behavioral Sciences, Center for Neurobehavioral Research on Addiction, University of Texas Health Science Center at Houston; Duke-National University of Singapore Graduate Medical School, Singapore; and VA North Texas Health Care System, Dallas.
authors.forename: Mary Ellen
authors.initials: ME
authors.lastname: Bret
authors.affiliation: From the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Psychiatry and Behavioral Sciences, Center for Neurobehavioral Research on Addiction, University of Texas Health Science Center at Houston; Duke-National University of Singapore Graduate Medical School, Singapore; and VA North Texas Health Care System, Dallas.
authors.forename: Traci
authors.initials: T
authors.lastname: Holmes
authors.affiliation: From the Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas; the Department of Psychiatry and Behavioral Sciences, Center for Neurobehavioral Research on Addiction, University of Texas Health Science Center at Houston; Duke-National University of Singapore Graduate Medical School, Singapore; and VA North Texas Health Care System, Dallas.
authors.forename: Alexander
authors.initials: A
authors.lastname: Lo
mesh_terms: D000328:Adult; D018692:Antimanic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000150:complications* / Q000188:drug therapy; D019970:Cocaine-Related Disorders / Q000150:complications / Q000188:drug therapy*; D003566:Cytidine Diphosphate Choline / Q000627:therapeutic use*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018697:Nootropic Agents / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D018692:Antimanic Agents; D018697:Nootropic Agents; D003566:Cytidine Diphosphate Choline