PHENYTOIN IN THE TREATMENT OF COCAINE ABUSE - A DOUBLE-BLIND-STUDY

Objectives: To evaluate the effectiveness of phenytoin in the treatmen t of cocaine abuse. Subjects and Methods: A 12-week, double blind, pla cebo-controlled outpatient study of phenytoin in the treatment of coca ine abuse was conducted, Sixty cocaine-using subjects were randomly as signed to a daily fixed dose of 300 mg phenytoin or placebo, Forty-fou r subjects initiated treatment and returned for weekly visits, Primary measures of outcome included weekly quantitative and qualitative coca ine urinalysis, self-reported cocaine use, global functioning and impr ovement, craving intensity, and subject retention. Results: Cocaine us e, as measured both by weekly urinalysis and self-report, was signific antly lower in the phenytoin group, The phenytoin group was also rated as significantly less impaired and more improved than the placebo gro up, Craving intensity was lower in the phenytoin group, but the differ ence was not statistically significant, Among phenytoin subjects, seru m phenytoin levels above 6.0 mu g/ml were associated with lon er rates of positive cocaine urine specimens and longer cocaine-free periods. No differences were observed between groups in study retention. Conclu sions: These findings suggest that phenytoin may be useful in the trea tment of cocaine abuse, Further studies are needed to replicate these findings.