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Clinical efficacy of gabapentin versus tiagabine for reducing cocaine use among cocaine dependent methadone-treated patients.
Drug Alcohol Depend. 2007 Feb 23; 87(1):1-9.DA

Abstract

BACKGROUND

GABAergic medications appear to reduce the reinforcing effects of cocaine by attenuating cocaine-induced dopamine release. This study evaluated gabapentin and tiagabine compared to placebo in reducing cocaine taking behavior.

METHODS

A total of 76 treatment seeking, cocaine dependent, methadone-treated, predominately Caucasian male subjects were randomly assigned to tiagabine 24 mg/day (N=25), gabapentin 2400 mg/day (N=26) or placebo (N=25) in a 10-week double-blind placebo-controlled trial. Study medications were slowly increased to their full dosages by the end of week 5 and maintained through week 10. The primary outcome measure was thrice-weekly drug free urine samples.

RESULTS

Treatment retention was significantly less for the gabapentin group relative to the other groups (log rank=5.29, d.f.=1, p=0.02). The proportion of cocaine-free urine samples during weeks 6-10 was significantly larger in the tiagabine treated group (p<0.05). The longitudinal data showed significant change in thrice-weekly cocaine free urines that reached a greater abstinent rate for the tiagabine treated group (22%) compared to gabapentin (5%) or placebo (13%) treated groups. Mixed-effects ordinal regression models showed a significant tiagabine by time interaction compared to gabapentin (Z=2.48, d.f.=1, p=0.01) and placebo (Z=3.90, d.f.=1, p=0.0001). The gabapentin group did not differ from placebo.

CONCLUSION

Gabapentin showed poor treatment retention and ineffectiveness in reducing cocaine use. Tiagabine significantly reduced cocaine taking behavior compared to placebo or gabapentin among methadone-stabilized cocaine abusers.

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Authors+Show Affiliations

González G
Department of Psychiatry, Yale University, New Haven, CT 06511, USA. gerardo.gonzalez-haddad@yale.edu
Desai R
No affiliation info available
Sofuoglu M
No affiliation info available
Poling J
No affiliation info available
Oliveto A
No affiliation info available
Gonsai K
No affiliation info available
Kosten TR
No affiliation info available

MeSH

AdultAminesAnti-Anxiety AgentsCocaine-Related DisordersCognitive Behavioral TherapyCombined Modality TherapyCyclohexanecarboxylic AcidsDouble-Blind MethodDrug Administration ScheduleFemaleGABA AgonistsGabapentinHumansMaleMethadoneNarcoticsNipecotic AcidsTiagabineTreatment Outcomegamma-Aminobutyric Acid

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

16930857

Citation

González, Gerardo, et al. "Clinical Efficacy of Gabapentin Versus Tiagabine for Reducing Cocaine Use Among Cocaine Dependent Methadone-treated Patients." Drug and Alcohol Dependence, vol. 87, no. 1, 2007, pp. 1-9.
González G, Desai R, Sofuoglu M, et al. Clinical efficacy of gabapentin versus tiagabine for reducing cocaine use among cocaine dependent methadone-treated patients. Drug Alcohol Depend. 2007;87(1):1-9.
González, G., Desai, R., Sofuoglu, M., Poling, J., Oliveto, A., Gonsai, K., & Kosten, T. R. (2007). Clinical efficacy of gabapentin versus tiagabine for reducing cocaine use among cocaine dependent methadone-treated patients. Drug and Alcohol Dependence, 87(1), 1-9.
González G, et al. Clinical Efficacy of Gabapentin Versus Tiagabine for Reducing Cocaine Use Among Cocaine Dependent Methadone-treated Patients. Drug Alcohol Depend. 2007 Feb 23;87(1):1-9. PubMed PMID: 16930857.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical efficacy of gabapentin versus tiagabine for reducing cocaine use among cocaine dependent methadone-treated patients. AU - González,Gerardo, AU - Desai,Rani, AU - Sofuoglu,Mehmet, AU - Poling,Jim, AU - Oliveto,Alison, AU - Gonsai,Kishor, AU - Kosten,Thomas R, Y1 - 2006/08/22/ PY - 2005/10/25/received PY - 2006/06/27/revised PY - 2006/07/01/accepted PY - 2006/8/26/pubmed PY - 2007/4/5/medline PY - 2006/8/26/entrez SP - 1 EP - 9 JF - Drug and alcohol dependence JO - Drug Alcohol Depend VL - 87 IS - 1 N2 - BACKGROUND: GABAergic medications appear to reduce the reinforcing effects of cocaine by attenuating cocaine-induced dopamine release. This study evaluated gabapentin and tiagabine compared to placebo in reducing cocaine taking behavior. METHODS: A total of 76 treatment seeking, cocaine dependent, methadone-treated, predominately Caucasian male subjects were randomly assigned to tiagabine 24 mg/day (N=25), gabapentin 2400 mg/day (N=26) or placebo (N=25) in a 10-week double-blind placebo-controlled trial. Study medications were slowly increased to their full dosages by the end of week 5 and maintained through week 10. The primary outcome measure was thrice-weekly drug free urine samples. RESULTS: Treatment retention was significantly less for the gabapentin group relative to the other groups (log rank=5.29, d.f.=1, p=0.02). The proportion of cocaine-free urine samples during weeks 6-10 was significantly larger in the tiagabine treated group (p<0.05). The longitudinal data showed significant change in thrice-weekly cocaine free urines that reached a greater abstinent rate for the tiagabine treated group (22%) compared to gabapentin (5%) or placebo (13%) treated groups. Mixed-effects ordinal regression models showed a significant tiagabine by time interaction compared to gabapentin (Z=2.48, d.f.=1, p=0.01) and placebo (Z=3.90, d.f.=1, p=0.0001). The gabapentin group did not differ from placebo. CONCLUSION: Gabapentin showed poor treatment retention and ineffectiveness in reducing cocaine use. Tiagabine significantly reduced cocaine taking behavior compared to placebo or gabapentin among methadone-stabilized cocaine abusers. SN - 0376-8716 UR - https://www.unboundmedicine.com/medline/citation/16930857/Clinical_efficacy_of_gabapentin_versus_tiagabine_for_reducing_cocaine_use_among_cocaine_dependent_methadone_treated_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0376-8716(06)00276-6 DB - PRIME DP - Unbound Medicine ER -