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Evidence summaries

Dopamine Agonists for Cocaine Dependence

Dopamine antagonists appear not to be effective for cocaine dependence. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 24 studies with a total of 2 147 subjects. Comparing any dopamine agonist vs placebo, no differences for any of the outcomes considered: dropout (moderate quality of evidence), abstinence (low quality of evidence), severity of dependence (low quality of evidence), adverse events (moderate quality of evidence). This was also observed when single dopamine agonists were compared against placebo. Comparing amantadine versus antidepressants, antidepressants performed better for abstinence (RR 0.25, 95% CI 0.12 to 0.53; 2 two studies, n=44). The other two outcomes considered did not show statistically significant differences although dropouts and adverse events tended to be more common in the antidepressant group.

Comment: The quality of evidence is downgraded by study limitations (unclear allocation concealment).

    References

    • Amato L, Minozzi S, Pani PP et al. Dopamine agonists for the treatment of cocaine dependence. Cochrane Database Syst Rev 2011;(12):CD003352 [Last assessed as up-to-date: 12 January 2015]. [PubMed]

Primary/Secondary Keywords