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Aripiprazole for cocaine abstinence: a randomized-controlled trial with ecological momentary assessment

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  • Source:
    Behavioural pharmacology 2017 28 1, 63 (63-73) Published by: Lippincott Williams and Wilkins (E-mail: [email protected]) United Kingdom
  • Additional Information
    • Author(s):
      Moran LM, Phillips KA, Kowalczyk WJ, Ghitza UE, Agage DA, Epstein DH, Preston KL
    • Contact Information:
      K.L. Prestona, Clinical Pharmacology and Therapeutics Research Branch, Intramural Research Program, Treatment Section, NIH National Institute on Drug Abuse, 251 Bayview Blvd. Suite 200, Baltimore, MD 21224, United States. E-mail: [email protected]
    • Language:
      English
    • Publication Type:
      Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Intramural
    • Record Status:
      This record is updated this issue.
    • Abstract:
      Aripiprazole blocks psychostimulant seeking in a rat model of relapse. However, in humans, it may increase ongoing use. We tested aripiprazole specifically for relapse prevention. Methadone-maintained outpatients who were abstinent from cocaine in weeks 11-12 were randomized to double-blind aripiprazole (15 mg daily) or placebo in weeks 13-27 after 12 weeks of contingency management. Participants reported craving through ecological momentary assessment. We stopped the trial because very few (18/41) participants fulfilled the abstinence criterion. The results suggested that aripiprazole delayed lapse [hazard ratio (HR)=0.45, 95% confidence interval (CI)=0.14-1.42, P=0.17] and relapse (HR=0.31, 95% CI=0.07-1.27, P=0.10), but the effects did not reach statistical significance. Unexpectedly, the proportion of participants reporting cocaine craving was higher in the aripiprazole group (Fisher's exact P=0.026), although the frequency of craving was similar in the aripiprazole and placebo groups (1.89 vs. 1.16%, reffect=0.43, 95% CI=-0.08-0.76). The results suggest that in recently abstinent cocaine users, aripiprazole might delay relapse, but might also slightly increase craving. Difficulty in trial implementation underscores the fact that initial abstinence from cocaine is not a trivial hurdle.
    • EMBASE keywords:
      adult; agitation; article; clinical article; confidence interval; controlled study; demography; double blind procedure; drug craving; drug dose escalation; drug dose reduction; *drug withdrawal; Ecological Momentary Assessment; female; Fisher exact test; hazard ratio; human; intention to treat analysis; irritability; male; paresthesia/si [Side Effect]; randomized controlled trial; relapse; restlessness/si [Side Effect]; self report; side effect/si [Side Effect]; suicidal ideation/si [Side Effect]; tremor/si [Side Effect]; *aripiprazole/ae [Adverse Drug Reaction]; *aripiprazole/cm [Drug Comparison]; *aripiprazole/po [Oral Drug Administration]; *cocaine; methadone; placebo; *abstinence; clinical trial; cocaine dependence; controlled clinical trial; craving; outpatient; statistical significance; *aripiprazole
      Adult
      Female
      Humans
      Male
      Middle Aged
      Cocaine-Related Disorders/psychology
      Double-Blind Method
      Ecological Momentary Assessment
      Methadone/administration & dosage
      Secondary Prevention
      Antipsychotic Agents/*therapeutic use
      Aripiprazole/*therapeutic use
      Cocaine-Related Disorders/*drug therapy
      Craving/*drug effects
    • Accession Number:
      612816828
    • Source:
      This document should be cited as: Moran LM Phillips KA Kowalczyk WJ Ghitza UE Agage DA Epstein DH Preston KL. Aripiprazole for cocaine abstinence: a randomized-controlled trial with ecological momentary assessment 2017 (The Cochrane Controlled Trials Register (CCTR/CENTRAL). DOI: 10.1097/FBP.0000000000000268. Oxford: Update Software. Updated quarterly.
    • Accession Number:
      CN-01332624
  • Citations
    • ABNT:
      MORAN LM et al. Aripiprazole for cocaine abstinence: a randomized-controlled trial with ecological momentary assessment. Behavioural pharmacology, [s. l.], v. 28, n. 1, p. 63–73, 2017. DOI 10.1097/FBP.0000000000000268. Disponível em: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=cgh&AN=CN-01332624. Acesso em: 21 set. 2020.
    • AMA:
      Moran LM, Phillips KA, Kowalczyk WJ, et al. Aripiprazole for cocaine abstinence: a randomized-controlled trial with ecological momentary assessment. Behavioural pharmacology. 2017;28(1):63-73. doi:10.1097/FBP.0000000000000268
    • APA:
      Moran LM, Phillips KA, Kowalczyk WJ, Ghitza UE, Agage DA, Epstein DH, & Preston KL. (2017). Aripiprazole for cocaine abstinence: a randomized-controlled trial with ecological momentary assessment. Behavioural Pharmacology, 28(1), 63–73. https://doi.org/10.1097/FBP.0000000000000268
    • Chicago/Turabian: Author-Date:
      Moran LM, Phillips KA, Kowalczyk WJ, Ghitza UE, Agage DA, Epstein DH, and Preston KL. 2017. “Aripiprazole for Cocaine Abstinence: A Randomized-Controlled Trial with Ecological Momentary Assessment.” Behavioural Pharmacology 28 (1): 63–73. doi:10.1097/FBP.0000000000000268.
    • Harvard:
      Moran LM et al. (2017) ‘Aripiprazole for cocaine abstinence: a randomized-controlled trial with ecological momentary assessment’, Behavioural pharmacology, 28(1), pp. 63–73. doi: 10.1097/FBP.0000000000000268.
    • Harvard: Australian:
      Moran LM, Phillips KA, Kowalczyk WJ, Ghitza UE, Agage DA, Epstein DH & Preston KL 2017, ‘Aripiprazole for cocaine abstinence: a randomized-controlled trial with ecological momentary assessment’, Behavioural pharmacology, vol. 28, no. 1, pp. 63–73, viewed 21 September 2020, .
    • MLA:
      Moran LM, et al. “Aripiprazole for Cocaine Abstinence: A Randomized-Controlled Trial with Ecological Momentary Assessment.” Behavioural Pharmacology, vol. 28, no. 1, Jan. 2017, pp. 63–73. EBSCOhost, doi:10.1097/FBP.0000000000000268.
    • Chicago/Turabian: Humanities:
      Moran LM, Phillips KA, Kowalczyk WJ, Ghitza UE, Agage DA, Epstein DH, and Preston KL. “Aripiprazole for Cocaine Abstinence: A Randomized-Controlled Trial with Ecological Momentary Assessment.” Behavioural Pharmacology 28, no. 1 (January 1, 2017): 63–73. doi:10.1097/FBP.0000000000000268.
    • Vancouver/ICMJE:
      Moran LM, Phillips KA, Kowalczyk WJ, Ghitza UE, Agage DA, Epstein DH, et al. Aripiprazole for cocaine abstinence: a randomized-controlled trial with ecological momentary assessment. Behavioural pharmacology [Internet]. 2017 Jan 1 [cited 2020 Sep 21];28(1):63–73. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=cgh&AN=CN-01332624