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Evidence summaries

Antipsychotic Medications for Cocaine Dependence

Antipsychotic medications are probably not effective in reducing cocaine dependence. Level of evidence: "C"

A Cochrane review [Abstract] 1 included 14 studies with a total of 719 subjects. The antipsychotic medications used were risperidone (5 studies); olanzapine (5 studies); quetiapine (2 studies); aripiprazol; lamotrigine; reserpine; and haloperidol (1 study each). Antipsychotics reduced dropout (any antipsychotic drugs vs placebo: RR 0.75, 95% CI 0.57 to 0.97; 8 trials, n=397; moderate quality of evidence). No significant differences were found for any other efficacy measures comparing any antipsychotic with placebo (number of participants using cocaine during the treatment, continuous abstinence, side effects, and craving). Comparisons of single drug versus placebo or versus another drug are conducted in few trials with small sample sizes.

Comment: The quality of evidence is downgraded by study quality (inadequate or unclear allocation concealment and blinding) and by imprecise results (limited study size for each comparison).

    References

    • Amato L, Minozzi S, Pani PP, Davoli M. Antipsychotic medications for cocaine dependence. Cochrane Database Syst Rev 2007 Jul 18;(3):CD006306 [Assessed as up-to-date: 15 July 2015]. [PubMed]

Primary/Secondary Keywords