Raby Wilfrid Noel, Coomaraswamy Siobhan
Division of Substance Abuse, Substance Treatment and Research Service Clinic, New York State Psychiatric Institute New York, NY 10032, USA.
J Clin Psychiatry. 2004 Jan;65(1):84-6. doi: 10.4088/jcp.v65n0114.
Individuals with chronic psychiatric conditions display a high rate of cocaine use. Gabapentin was hypothesized to reduce cocaine use by restoring inhibitory GABAergic feedback on ascending dopaminergic projections to nucleus accumbens neurons.
Nine participants with DSM-IV cocaine dependence were selected from patients attending a large community psychiatric clinic. During a 24-week open-label trial of gabapentin (800-2400 mg/day), qualitative urine drug screens were collected from the participants up to 3 times per week. Data were collected from September 1999 to May 2001.
With gabapentin, the mean +/- SD number of cocaine-positive urine screens decreased from 53.11 +/- 13.23 to 35.22 +/- 14.84 (t = 3.58, N = 9, p <.01). The number of weeks of abstinence from cocaine increased from 2.1 +/- 1.5 to 8.0 +/- 5.5 (t = 3.21, N = 9, p <.01).
Gabapentin appeared to be a safe and efficacious medication to reduce cocaine usage in a community sample of psychiatric patients.
患有慢性精神疾病的个体可卡因使用率很高。加巴喷丁被推测可通过恢复对伏隔核神经元的多巴胺能上行投射的抑制性γ-氨基丁酸(GABA)能反馈来减少可卡因使用。
从一家大型社区精神病诊所的患者中挑选出9名符合《精神疾病诊断与统计手册》第四版(DSM-IV)可卡因依赖标准的参与者。在为期24周的加巴喷丁开放标签试验(800 - 2400毫克/天)期间,每周最多3次收集参与者的定性尿液药物筛查样本。数据收集时间为1999年9月至2001年5月。
服用加巴喷丁后,可卡因阳性尿液筛查样本的平均±标准差数量从53.11±13.23降至35.22±14.84(t = 3.58,N = 9,p <.01)。可卡因戒断周数从2.1±1.5增加到8.0±5.5(t = 3.21,N = 9,p <.01)。
在一组社区精神病患者样本中,加巴喷丁似乎是一种安全有效的减少可卡因使用的药物。