TY - JOUR
KW - Anticonvulsants/therapeutic use
KW - Antidepressive Agents/therapeutic use
KW - Antipsychotic Agents/therapeutic use
KW - Central Nervous System Stimulants/therapeutic use
KW - Cocaine-Related Disorders/drug therapy
KW - Disulfiram/therapeutic use
KW - Humans
KW - Naltrexone/therapeutic use
AU - J. Buchholz
AU - A. J. Saxon
A1 - 
AB - PURPOSE OF REVIEW: Cocaine is a highly addictive substance with serious medical and mental health consequences. Despite these concerns, there are no Food and Drug Administration-approved medications for the treatment of cocaine use disorder (CUD). Although many medication-assisted treatments (MATs) have been investigated, no clear guidelines exist for clinicians treating patients with CUDs. RECENT FINDINGS: There are a limited number of recent data examining MATs for CUD. Multiple high-quality reviews of existing literature have been performed with psychostimulants, modafinil, bupropion, topiramate and disulfiram showing the most promise. Evidence is limited by heterogeneity of studies, small sample sizes and inconsistent results. SUMMARY: The current literature does not strongly support any individual MAT for CUD. Psychosocial interventions, namely contingency management, have the most evidence for treatment of CUD, but it is worth seriously considering MAT for patients who do not respond well to psychosocial interventions alone given limitations in access to care, relatively low risks associated with MAT and significant morbidity associated with CUD. Further research into MAT for CUD is necessary, as the combination of MAT and psychosocial interventions may be better than either alone.
AD - Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Inpatient Psychiatry.; Addiction Psychiatry Residency Program, Department of Psychiatry & Behavioral Sciences, University of Washington School of Medicine, Director, Center of Excellence in Substance Abuse Treatment and Education (CESATE), VA Puget Sound Healthcare System, Seattle, Washington, USA.
BT - Current opinion in psychiatry
C5 - Healthcare Disparities; Opioids & Substance Use
CP - 4
CY - United States
DO - 10.1097/YCO.0000000000000518
IS - 4
JF - Current opinion in psychiatry
LA - eng
M1 - Journal Article
N2 - PURPOSE OF REVIEW: Cocaine is a highly addictive substance with serious medical and mental health consequences. Despite these concerns, there are no Food and Drug Administration-approved medications for the treatment of cocaine use disorder (CUD). Although many medication-assisted treatments (MATs) have been investigated, no clear guidelines exist for clinicians treating patients with CUDs. RECENT FINDINGS: There are a limited number of recent data examining MATs for CUD. Multiple high-quality reviews of existing literature have been performed with psychostimulants, modafinil, bupropion, topiramate and disulfiram showing the most promise. Evidence is limited by heterogeneity of studies, small sample sizes and inconsistent results. SUMMARY: The current literature does not strongly support any individual MAT for CUD. Psychosocial interventions, namely contingency management, have the most evidence for treatment of CUD, but it is worth seriously considering MAT for patients who do not respond well to psychosocial interventions alone given limitations in access to care, relatively low risks associated with MAT and significant morbidity associated with CUD. Further research into MAT for CUD is necessary, as the combination of MAT and psychosocial interventions may be better than either alone.
PP - United States
PY - 2019
SN - 1473-6578; 0951-7367
SP - 275
EP - 281
EP - 
T1 - Medications to treat cocaine use disorders: current options
T2 - Current opinion in psychiatry
TI - Medications to treat cocaine use disorders: current options
U1 - Healthcare Disparities; Opioids & Substance Use
U2 - 31008728
U3 - 10.1097/YCO.0000000000000518
VL - 32
VO - 1473-6578; 0951-7367
Y1 - 2019
Y2 - Jul
ER -