Efficacy of Disulfiram and Cognitive Behavior Therapy in Cocaine-DependentOutpatients

Carroll, Kathleen M.; Fenton, Lisa R.; Ball, Samuel A.; Nich, Charla; Frankforter, Tami L.; Shi, Julia; Rounsaville, Bruce J.

doi:10.1001/archpsyc.61.3.264

Cited by 395 publications

(275 citation statements)

References 64 publications

(62 reference statements)

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“…Although preliminary findings indeed supported the efficacy of disulfiram in cocaine/alcohol codependent individuals (Carroll et al, 1998, results from three recent studies strongly suggest that comorbid alcohol use is not necessary for disulfiram treatment of cocaine dependenceFin fact, nonalcohol-dependent subjects may derive even more benefit from disulfiram treatment than those who also abuse alcohol (George et al, 2000;Petrakis et al, 2000;Carroll et al, 2004). Because the drug combination of disulfiram and cocaine in the absence of alcohol does not result in acetaldehyde accumulation, the reduction of cocaine use with disulfiram treatment must depend on an interaction other than inhibition of aldehyde dehydrogenase.…”

Section: Disulfiram and Cocaine Dependencementioning

confidence: 92%

There and Back Again: A Tale of Norepinephrine and Drug Addiction

Weinshenker

Schroeder

2006

Neuropsychopharmacol

319

277

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Fueled by anatomical, electrophysiological, and pharmacological analyses of endogenous brain reward systems, norepinephrine (NE) was identified as a key mediator of both natural and drug-induced reward in the late 1960s and early 1970s. However, reward experiments from the mid-1970s that could distinguish between the noradrenergic and dopaminergic systems resulted in the prevailing view that dopamine (DA) was the primary 'reward transmitter' (a belief holding some sway still today), thereby pushing NE into the background. Most damaging to the NE hypothesis of reward were studies demonstrating that NE receptor antagonists and NE reuptake inhibitors failed to impact drug self-administration. In recent years new tools, such as genetically engineered mice, and new experimental paradigms, such as reinstatement of drug seeking following withdrawal, have propelled NE back into the awareness of addiction researchers. Of particular interest is disulfiram, an inhibitor of the NE biosynthetic enzyme dopamine b-hydroxylase, which has demonstrated promising efficacy in the treatment of cocaine dependence in preliminary clinical trials. The purpose of this review is to synthesize the new data linking NE to critical aspects of DA signaling and drug addiction, with a focus on psychostimulants (eg, cocaine), opiates (eg, morphine), and alcohol.

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Section: Disulfiram and Cocaine Dependencementioning

confidence: 92%

There and Back Again: A Tale of Norepinephrine and Drug Addiction

Weinshenker

Schroeder

2006

Neuropsychopharmacol

319

277

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“…Adapted from the Time Line Follow-Back interview (Sobell & Sobell, 1992), which has been shown to be a reliable and valid instrument for monitoring substance use (Fals-Stewart, O'Farrell, Freitas, McFarlin, & Rutigliano, 2000), the SUC uses a similar calendar method to allow for a continuous and reliable evaluation of daily substance use (Carroll et al, 2004).…”

Section: Assessment Proceduresmentioning

confidence: 99%

Site matters: Multisite randomized trial of motivational enhancement therapy in community drug abuse clinics.

Ball

Martino

Nich

et al. 2007

Journal of Consulting and Clinical Psychology

Self Cite

167

234

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The effectiveness of motivational enhancement therapy (MET) in comparison with counseling as usual (CAU) for increasing retention and reducing substance use was evaluated in a multisite randomized clinical trial. Participants were 461 outpatients treated by 31 therapists within 1 of 5 outpatient substance abuse programs. There were no retention differences between the 2 brief intervention conditions. Although both 3-session interventions resulted in reductions in substance use during the 4-week therapy phase, MET resulted in sustained reductions during the subsequent 12 weeks whereas CAU was associated with significant increases in substance use over this followup period. This finding was complicated by program site main effects and higher level interactions. MET resulted in more sustained substance use reductions than CAU among primary alcohol users, but no difference was found for primary drug users. An independent evaluation of session audiotapes indicated that MET and CAU were highly and comparably discriminable across sites.

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“…However, recent controlled trials of several medications, namely, disulfiram, topiramate, modafinil, and others, suggested that some medications added to counseling may provide an advantage over placebo treatment for cocaine dependence (See respectively : Carroll, Fenton, Ball, Nich et al, 2004;Dackis, Kampman, Lynch, Pettinati et al, 2005;Kampman, Pettinati, Lynch, Dackis et al, 2004). To date, however, disulfiram has had more published articles than any other medication in support for its use in the treatment of cocaine dependence (see Carroll et al, 2004;Carroll, Nich, Ball, McCance et al, 2000;Carroll, Nich, Ball, Mccance et al, 1998;Gossop & Carroll, 2006;Grassi, Cioceb, Dei Giudicib, Antonillia et al, 2007), particularly in men (Nich, McCance-Katzb, Petrakis, Cubellsa et al, 2004;Petrakis, Carroll, Nich, Gordon et al, 2000).…”

Section: Introductionmentioning

confidence: 99%

A double blind, placebo-controlled trial that combines disulfiram and naltrexone for treating co-occurring cocaine and alcohol dependence

Pettinati

Kampman

Lynch

et al. 2008

Addictive Behaviors

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BACKGROUND-This is a double blind, placebo-controlled trial that evaluated the efficacy of disulfiram, naltrexone and their combination in patients with co-occurring cocaine and alcohol dependence.METHODS-208 patients were randomized to disulfiram (250mg/day), naltrexone (100mg/day), the combination, or placebo for 11 weeks. Outcomes were in-trial abstinence from cocaine and/or alcohol.RESULTS-Few safety concerns were reported, although medication adherence was low in a number of patients for both medications, alone or in combination. In the primary analyses (GEE modeling), abstinence from cocaine as measured by cocaine-negative urines and days of self-reported abstinence from cocaine or alcohol did not differ between placebo and any of the medication groups. However, patients taking disulfiram (alone or in combination) were most likely to achieve combined abstinence from cocaine and alcohol. Secondary analyses revealed that patients taking the disulfiramnaltrexone combination were most likely to achieve 3 consecutive weeks of abstinence from cocaine and alcohol.CONCLUSION-There was an association between disulfiram treatment and abstinence from cocaine and alcohol. More patients taking the disulfiram-naltrexone combination achieved 3 consecutive weeks of abstinence in treatment than placebo-treated patients.

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Efficacy of Disulfiram and Cognitive Behavior Therapy in Cocaine-DependentOutpatients

Abstract: Disulfiram and CBT are effective therapies for general populations of cocaine-dependent individuals. Disulfiram seems to exert a direct effect on cocaine use rather than through reducing concurrent alcohol use.

Cited by 395 publications

References 64 publications

There and Back Again: A Tale of Norepinephrine and Drug Addiction

There and Back Again: A Tale of Norepinephrine and Drug Addiction

Site matters: Multisite randomized trial of motivational enhancement therapy in community drug abuse clinics.

A double blind, placebo-controlled trial that combines disulfiram and naltrexone for treating co-occurring cocaine and alcohol dependence

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