Kennedy Annette, Wood Amanda Ernst, Saxon Andrew J, Malte Carol, Harvey Megan, Jurik Jennifer, Kilzieh Nael, Lofgreen Cassin, Tapp Andre
Mental Illness Research, Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA.
J Clin Psychopharmacol. 2008 Apr;28(2):221-4. doi: 10.1097/JCP.0b013e318166f50d.
The monaminergic properties of second generation antipsychotics are prompting research on their use to treat cocaine dependence, with inconclusive results to date. In preliminary reports, the atypical antipsychotic quetiapine has shown promise for the treatment of substance abuse disorders. The primary objective of the current study was to assess the efficacy of quetiapine in reducing cocaine cravings and use in nonpsychotic subjects with cocaine dependence over 6 weeks of open-label treatment. Twenty-two cocaine-dependent, nonpsychotic men were initiated to open-label treatment with quetiapine (300-600 mg/d). The primary outcome measure was weekly self-report of cocaine cravings as assessed with the Brief Substance Craving Scale. Cocaine use was captured with a self-report Timeline Follow-back calendar, administered every 2 weeks. Side effect monitoring was conducted weekly, and movement disorders were assessed every 2 weeks. Intent-to-treat regression analyses (n = 22) indicated that the Brief Substance Craving Scale total score decreased significantly overtime (P < 0.001). Self-reports also suggested decreased cocaine use. There was no treatment-related increase in movement disorders, and most side effects were mild. However, all subjects did experience sedation, and several subjects dropped out because of it. What is more, weight increased significantly over time (P < 0.001). Open-label quetiapine treatment reduced cravings and improved some aspects of cocaine dependence in nonpsychotic individuals. Additional research is needed to confirm the current findings and to further delineate the role quetiapine may play in the treatment of cocaine use disorders.
第二代抗精神病药物的单胺能特性促使人们对其用于治疗可卡因依赖展开研究，迄今为止结果尚无定论。在初步报告中，非典型抗精神病药物喹硫平已显示出治疗物质使用障碍的前景。本研究的主要目的是评估喹硫平在为期6周的开放标签治疗中，减少可卡因依赖的非精神病患者对可卡因的渴望及使用的疗效。22名依赖可卡因的非精神病男性开始接受喹硫平开放标签治疗（300 - 600毫克/天）。主要结局指标是使用简短物质渴望量表评估的每周可卡因渴望自我报告。使用自我报告的时间线追溯日历每2周记录一次可卡因使用情况。每周进行副作用监测，每2周评估一次运动障碍。意向性治疗回归分析（n = 22）表明，简短物质渴望量表总分随时间显著下降（P < 0.001）。自我报告也显示可卡因使用减少。运动障碍没有因治疗而增加，且大多数副作用较轻。然而，所有受试者均出现了镇静作用，有几名受试者因此退出。此外，体重随时间显著增加（P < 0.001）。开放标签的喹硫平治疗减少了非精神病个体对可卡因的渴望，并改善了可卡因依赖的某些方面。需要进一步的研究来证实当前的发现，并进一步阐明喹硫平在治疗可卡因使用障碍中可能发挥的作用。
