Phenytoin in the treatment of cocaine abuse: a double-blind study

Clinical Pharmacology and Therapeutics
R D CrosbyN L Graves

Abstract

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 studie...Continue Reading

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Citations

Jul 2, 2005·Journal of Psychiatric Practice·C J Welsh, J Liberto
Jul 30, 2002·Addiction·Maurício Silva de LimaMichael Farrell
May 1, 2010·Expert Review of Clinical Pharmacology·Lindsey I SinclairAndrea L Malizia
Sep 17, 2004·Drug and Alcohol Review·James Shearer, Linda R Gowing

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