Crosby R D, Pearson V L, Eller C, Winegarden T, Graves N L
Department of Psychiatry, University of Minnesota, Minneapolis, USA.
Clin Pharmacol Ther. 1996 Apr;59(4):458-68. doi: 10.1016/S0009-9236(96)90116-2.
To evaluate the effectiveness of phenytoin in the treatment of cocaine abuse.
A 12-week, double-blind, placebo-controlled outpatient study of phenytoin in the treatment of cocaine abuse was conducted. Sixty cocaine-using subjects were randomly assigned to a daily fixed dose of 300 mg phenytoin or placebo. Forty-four subjects initiated treatment and returned for weekly visits. Primary measures of outcome included weekly quantitative and qualitative cocaine urinalysis, self-reported cocaine use, global functioning and improvement, craving intensity, and subject retention.
Cocaine use, as measured both by weekly urinalysis and self-report, was significantly lower in the phenytoin group. The phenytoin group was also rated as significantly less impaired and more improved than the placebo group. Craving intensity was lower in the phenytoin group, but the difference was not statistically significant. Among phenytoin subjects, serum phenytoin levels above 6.0 micrograms/ml were associated with lower rates of positive cocaine urine specimens and longer cocaine-free periods. No differences were observed between groups in study retention.
These findings suggest that phenytoin may be useful in the treatment of cocaine abuse. Further studies are needed to replicate these findings.
评估苯妥英钠治疗可卡因滥用的有效性。
开展了一项为期12周的门诊双盲安慰剂对照研究，以探讨苯妥英钠治疗可卡因滥用的效果。60名使用可卡因的受试者被随机分配至每日固定剂量300毫克苯妥英钠组或安慰剂组。44名受试者开始治疗并每周复诊。主要结局指标包括每周可卡因尿液定量和定性分析、自我报告的可卡因使用情况、整体功能及改善情况、渴望强度以及受试者留存率。
通过每周尿液分析和自我报告衡量，苯妥英钠组的可卡因使用量显著更低。与安慰剂组相比，苯妥英钠组的功能受损程度也显著更低，改善情况更好。苯妥英钠组的渴望强度更低，但差异无统计学意义。在使用苯妥英钠的受试者中，血清苯妥英钠水平高于6.0微克/毫升与可卡因尿液标本阳性率较低及无可卡因使用期较长相关。两组在研究留存率方面未观察到差异。
这些发现表明苯妥英钠可能对治疗可卡因滥用有用。需要进一步研究来重复这些发现。
