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Clinical efficacy of sertraline alone and augmented with gabapentin in recently abstinent cocaine-dependent patients with depressive symptoms.
J Clin Psychopharmacol. 2014 Apr; 34(2):234-9.JC

Abstract

BACKGROUND

Cocaine dependence is a major public health problem with no available robustly effective pharmacotherapy. This study's aim was to determine if treatment with sertraline (SERT) or SERT plus gabapentin (GBP) improved treatment retention, depressive symptoms, and/or cocaine use.

METHODS

Depressed cocaine-dependent patients (N = 99) were enrolled in a 12-week, double-blind, randomized, placebo (PLA)-controlled, clinical trial and placed in research beds at a residential treatment facility (Recovery Centers of Arkansas). They were randomized by depressive symptom severity and inducted onto 1 of the following while residing at the Recovery Centers of Arkansas: SERT (200 mg/d), SERT (200 mg/d) plus GBP (1200 mg/d), or PLA. Participants transferred to outpatient treatment at the start of their third week, continued receiving study medications or PLA (weeks 3-12), and participated in weekly individual cognitive behavioral therapy. Compliance was facilitated through the use of contingency management procedures. Supervised urine samples were obtained thrice weekly and self-reported mood weekly. At the end of 12 weeks, participants were tapered off the study medication over 5 days and referred to a local treatment program.

RESULTS

Sertraline, but not SERT plus GBP, showed a significantly lower overall percentage of cocaine-positive urine samples compared with that of PLA. A significantly greater percentage of participants experienced relapse in the PLA group (88.9%) compared with that of the SERT group (65.2%). Hamilton depression ratings decreased significantly over time regardless of the treatment group. Retention in treatment did not differ significantly between the treatment groups.

CONCLUSIONS

Sertraline plus GBP may not be superior to SERT alone in delaying relapse among abstinent cocaine-dependent individuals undergoing cognitive behavioral therapy.

Authors+Show Affiliations

From the *Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR; †Department of Psychiatry, VA Boston Healthcare System, Brockton, MA; ‡Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR; and §Department of Psychiatry, Baylor College of Medicine and Michael E DeBakey VA Medical Center, Houston, TX.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24525654

Citation

Mancino, Michael J., et al. "Clinical Efficacy of Sertraline Alone and Augmented With Gabapentin in Recently Abstinent Cocaine-dependent Patients With Depressive Symptoms." Journal of Clinical Psychopharmacology, vol. 34, no. 2, 2014, pp. 234-9.
Mancino MJ, McGaugh J, Chopra MP, et al. Clinical efficacy of sertraline alone and augmented with gabapentin in recently abstinent cocaine-dependent patients with depressive symptoms. J Clin Psychopharmacol. 2014;34(2):234-9.
Mancino, M. J., McGaugh, J., Chopra, M. P., Guise, J. B., Cargile, C., Williams, D. K., Thostenson, J., Kosten, T. R., Sanders, N., & Oliveto, A. (2014). Clinical efficacy of sertraline alone and augmented with gabapentin in recently abstinent cocaine-dependent patients with depressive symptoms. Journal of Clinical Psychopharmacology, 34(2), 234-9. https://doi.org/10.1097/JCP.0000000000000062
Mancino MJ, et al. Clinical Efficacy of Sertraline Alone and Augmented With Gabapentin in Recently Abstinent Cocaine-dependent Patients With Depressive Symptoms. J Clin Psychopharmacol. 2014;34(2):234-9. PubMed PMID: 24525654.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical efficacy of sertraline alone and augmented with gabapentin in recently abstinent cocaine-dependent patients with depressive symptoms. AU - Mancino,Michael J, AU - McGaugh,Janette, AU - Chopra,Mohit P, AU - Guise,Joseph B, AU - Cargile,Christopher, AU - Williams,D Keith, AU - Thostenson,Jeff, AU - Kosten,Thomas R, AU - Sanders,Nichole, AU - Oliveto,Alison, PY - 2014/2/15/entrez PY - 2014/2/15/pubmed PY - 2014/11/5/medline SP - 234 EP - 9 JF - Journal of clinical psychopharmacology JO - J Clin Psychopharmacol VL - 34 IS - 2 N2 - BACKGROUND: Cocaine dependence is a major public health problem with no available robustly effective pharmacotherapy. This study's aim was to determine if treatment with sertraline (SERT) or SERT plus gabapentin (GBP) improved treatment retention, depressive symptoms, and/or cocaine use. METHODS: Depressed cocaine-dependent patients (N = 99) were enrolled in a 12-week, double-blind, randomized, placebo (PLA)-controlled, clinical trial and placed in research beds at a residential treatment facility (Recovery Centers of Arkansas). They were randomized by depressive symptom severity and inducted onto 1 of the following while residing at the Recovery Centers of Arkansas: SERT (200 mg/d), SERT (200 mg/d) plus GBP (1200 mg/d), or PLA. Participants transferred to outpatient treatment at the start of their third week, continued receiving study medications or PLA (weeks 3-12), and participated in weekly individual cognitive behavioral therapy. Compliance was facilitated through the use of contingency management procedures. Supervised urine samples were obtained thrice weekly and self-reported mood weekly. At the end of 12 weeks, participants were tapered off the study medication over 5 days and referred to a local treatment program. RESULTS: Sertraline, but not SERT plus GBP, showed a significantly lower overall percentage of cocaine-positive urine samples compared with that of PLA. A significantly greater percentage of participants experienced relapse in the PLA group (88.9%) compared with that of the SERT group (65.2%). Hamilton depression ratings decreased significantly over time regardless of the treatment group. Retention in treatment did not differ significantly between the treatment groups. CONCLUSIONS: Sertraline plus GBP may not be superior to SERT alone in delaying relapse among abstinent cocaine-dependent individuals undergoing cognitive behavioral therapy. SN - 1533-712X UR - https://www.unboundmedicine.com/medline/citation/24525654/Clinical_efficacy_of_sertraline_alone_and_augmented_with_gabapentin_in_recently_abstinent_cocaine_dependent_patients_with_depressive_symptoms_ L2 - https://doi.org/10.1097/JCP.0000000000000062 DB - PRIME DP - Unbound Medicine ER -