Ziedonis D, Richardson T, Lee E, Petrakis I, Kosten T
Department of Psychiatry, Yale University, New Haven, CT.
Psychopharmacol Bull. 1992;28(3):309-14.
Because schizophrenic patients have a lifetime prevalence rate for cocaine abuse between 15 and 50 percent, the use of adjunctive pharmacotherapy should be considered in cocaine-abuse treatment programs. This 12-week, open-label outpatient study compares 12 cocaine-abusing schizophrenic patients treated with desipramine (DMI) 100 to 150 mg and antipsychotic agents to 15 patients treated with only antipsychotic agents (no DMI). All 27 patients participated in a Dual Diagnosis Relapse Prevention (DDRP) program, which integrates traditional substance-abuse relapse prevention and psychiatric social skills training. The DMI group was more likely to complete the study (83% vs. 60%, odds ratio = 3.3, NS) and had fewer cocaine-positive urines during the last 6 weeks (20% vs. 50%, odds ratio = 4.0, p < .01). In the context of a specialized dual diagnosis treatment program, patients receiving DMI substantially decreased cocaine usage and had improved psychiatric symptoms.
由于精神分裂症患者中可卡因滥用的终生患病率在15%至50%之间，因此在可卡因滥用治疗项目中应考虑使用辅助药物治疗。这项为期12周的开放标签门诊研究比较了12名接受100至150毫克地昔帕明（DMI）和抗精神病药物治疗的可卡因滥用精神分裂症患者与15名仅接受抗精神病药物治疗（无DMI）的患者。所有27名患者都参加了双诊断复发预防（DDRP）项目，该项目整合了传统的药物滥用复发预防和精神科社交技能培训。DMI组更有可能完成研究（83%对60%，优势比=3.3，无显著性差异），并且在最后6周内可卡因阳性尿液较少（20%对50%，优势比=4.0，p<0.01）。在专门的双诊断治疗项目背景下，接受DMI治疗的患者可卡因使用量大幅下降，精神症状得到改善。
