Beta blocker treatment of heart failure patients with ongoing cocaine use

Littmann, László; Narveson, Sara Y.; Fesel, Nicole M.; Marconi, Sarah L.

doi:10.1016/j.ijcard.2013.03.187

Cited by 12 publications

(21 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As mentioned before, case reports suggest potential effectiveness of CAR for the treatment of cocaine-induced cardiac toxicity and ischemia (Littmann et al, 2013; Ocal et al, 2015; Self et al, 2011). It has been suggested that CAR may have an advantage over pure beta-adrenergic blockers like propranolol for attenuating the cardiovascular stimulation induced by cocaine use (Damodaran, 2010).…”

Section: Discussionmentioning

confidence: 79%

“…CAR may also have utility for the treatment of cocaine addiction as indicated by a human laboratory study in which CAR attenuated both cocaine-induced blood pressure and heart rate increases, as well as cocaine self-administration behavior (Sofuoglu, Brown, Babb, Pentel, & Hatsukami, 2000). In addition, CAR has been administered to cocaine users for the treatment of cardiac disorders including myocardial infarction, heart failure and cocaine-induced cardiac toxicity (Littmann, Narveson, Fesel, & Marconi, 2013; Ocal et al, 2015; Self, Rogers, Mancell, & Soberman, 2011). However, no previous studies have examined the safety and efficacy of CAR for the treatment of CUD.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Carvedilol does not reduce cocaine use in methadone-maintained cocaine users

Sofuoglu¹,

Poling²,

Babuscio³

et al. 2017

Journal of Substance Abuse Treatment

View full text Add to dashboard Cite

Introduction The goal of this study was too test the efficacy of carvedilol (CAR), an adrenergic blocker, for reducing cocaine use in individuals with cocaine use disorder (CUD). We conducted a 17-week, double-blind, randomized controlled trial with 3 treatment arms: 25 mg CAR, 50 mg CAR, and placebo. Methods One hundred and six treatment-seeking opioid and cocaine-dependent participants, who were also maintained on methadone during study participation, were randomized to placebo (n=34), 25 mg/day CAR (n=37) or 50 mg/day CAR (n=35). The main outcome measures were cocaine and opioid use as assessed by urine drug screening and self-reported drug use. Results No significant group differences were found for treatment retention with 56 % of the placebo, 76 % of the 25 mg and 66 % of the 50 mg CAR groups (p>0.05) completing treatment. The percentage (SD) of cocaine positive urines during the trial showed an overall treatment effect: 59.2 (38.9) for the placebo, 50.8 (33.8) for the 25mg and 75.1 (33.2) for the 50 mg CAR group. In post hoc comparisons, neither the 25 nor 50 mg CAR condition differed significantly from the placebo; however, the 25 mg CAR group had a significantly lower proportion of cocaine-positive urines than the 50 mg group. No significant group differences were found for the percentage of self-reported days of cocaine abstinence during the trial: 72.9 (25.3) for placebo, 72.9 (29) for CAR 25 mg, and 59.3 (31.7) for CAR 50 mg. Significant groups differences in the proportion of opioid positive urines submitted were not observed (p>0.05). Baseline cocaine withdrawal severity did not predict treatment response (p>0.05). Conclusions These findings did not support the efficacy of CAR for the treatment of cocaine use in cocaine and opioid dependent participants maintained on methadone. Further, CAR doses greater than 25 mg should not be used to avoid possible increases in cocaine and opioid use.

show abstract

Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Carvedilol does not reduce cocaine use in methadone-maintained cocaine users

Sofuoglu¹,

Poling²,

Babuscio³

et al. 2017

Journal of Substance Abuse Treatment

View full text Add to dashboard Cite

show abstract

“…The use of beta-blocking drugs as single agents is contraindicated. For the purpose of these patients need to know and be used in medical practice cardiac magnetic resonance as a method that is quite useful for predicts reversibility of cocaine-induced ventricular dysfunction (1,14,15,16).…”

Section: Managementmentioning

confidence: 99%

Cocaine cardiomyopathy: A case report

Greco¹,

Zhivadinovik²

2014

SANAMED

View full text Add to dashboard Cite

Abstract:Cocaine is the second most common illicit drug used and the most frequent cause of drug related deaths. The use of cocaine is associated with both, acute and chronic complications, that may involve any system, but the most common system affected is cardiovascular one. Cocaine cardiomyopathy may result from the use of cocaine.This article presents a first case in Republic of Macedonia of 24-year-old male with reversible cocaine-related cardiomyopathy. Clinical presentation, laboratory, X-ray, ultrasound findings and treatment are reviewed.

show abstract

“…Cocaine-mediated smooth muscle vasospasm is driven by α-adrenergic stimulation and use of a selective β-adrenergic blocking drug may lead to unopposed α-adrenergic vasospasm and make both systemic hypertension and coronary artery spasm worse. 57 Some retrospective data exist to suggest that beta blocker use may reduce complications when used for cocaine-associated myocardial infarction, 58,59 but no randomized studies exist. 55,56 Labetalol has been proposed as preferable to other beta blockers due to its combined αand β-blocking properties, but it is predominantly β-blocking and does not appear to be significantly different from other beta blockers.…”

Section: Beta Blockersmentioning

confidence: 99%