Anticonvulsant drugs in cocaine dependence: A systematic review and meta-analysis

Alvarez, Yolanda; Farré, Magí; Fonseca, Francina; Torrens, Marta

doi:10.1016/j.jsat.2009.07.001

« Previous Next »Journal of Substance Abuse Treatment
Volume 38, Issue 1 , Pages 66-73, January 2010

Anticonvulsant drugs in cocaine dependence: A systematic review and meta-analysis

Yolanda Alvarez, M.D.
- Human Pharmacology Unit, IMIM-Hospital del Mar, E-08003 Barcelona, Spain
- Autonomous University of Barcelona (Department of Pharmacology and Department of Psychiatry), E-08003 Barcelona, Spain
- Authorship credit should be equally distributed among the authors independently of the order.
Magí Farré, M.D., Ph.D.
- Human Pharmacology Unit, IMIM-Hospital del Mar, E-08003 Barcelona, Spain
- Autonomous University of Barcelona (Department of Pharmacology and Department of Psychiatry), E-08003 Barcelona, Spain
- Corresponding author. Drug Addiction Unit, IAPS-Hospital del Mar, Paseo Maritimo 25, E-08003 Barcelona, Spain. Tel.: +34 932483175; fax: +34 933160410.
- Authorship credit should be equally distributed among the authors independently of the order.
Francina Fonseca, M.D.
- Drug Addiction Unit, IAPS-Hospital del Mar, E-08003 Barcelona, Spain
- Authorship credit should be equally distributed among the authors independently of the order.
Marta Torrens, M.D., Ph.D.
- Autonomous University of Barcelona (Department of Pharmacology and Department of Psychiatry), E-08003 Barcelona, Spain
- Drug Addiction Unit, IAPS-Hospital del Mar, E-08003 Barcelona, Spain
- Authorship credit should be equally distributed among the authors independently of the order.

Received 9 April 2009; received in revised form 25 May 2009; accepted 17 July 2009. published online 01 September 2009.

Abstract

A systematic review and meta-analysis according to the methodology developed by the Cochrane Collaboration and the Quality of Reporting of Meta-Analyses statement based on randomized controlled trials to evaluate the efficacy of anticonvulsants in subjects with cocaine dependence were performed. Fifteen randomized, double-blind, placebo-controlled clinical trials involving 1,236 patients were included. Two outcome measures were evaluated: retention in the anticonvulsant treatment (compared to the placebo treatment) and the subsequent cocaine use, measured by urinalysis results. The efficacy of the seven anticonvulsant drugs analyzed was not homogenous. On average, 50% of the enrolled participants were lost to follow-up. Treatments did not show an improvement in subject retention compared to placebo. Overall, the number of cocaine-positive urine samples was close to statistical significance (95% confidence interval = 0.85–1.06) compared to placebo. Available clinical trials indicate that there is insufficient evidence to justify the use of anticonvulsant drugs in treating cocaine dependence.

Keywords: Systematic review, Meta-analysis, Anticonvulsant, Cocaine dependence, Retention