DIETHYLPROPION PHARMACOTHERAPEUTIC ADJUVANT THERAPY FOR INPATIENT TREATMENT OF COCAINE DEPENDENCE - A TEST OF THE COCAINE-AGONIST HYPOTHESIS

Fifty cocaine-dependent patients completed a 2-week double-blind, doub le-dummy, parallel-group comparison of four dosage levels of diethylpr opion and placebo. This clinical trial was designed to evaluate both d iethylpropion's ability to attenuate cocaine cue-induced craving and i ts potential for development as a medication with cocaine-agonist prop erties. The results indicated that diethylpropion was not superior to placebo and confirmed earlier reports that craving for cocaine diminis hes over the course of an inpatient hospitalization. Moreover, the res ults showed that the cocaine cue-induced craving paradigm employed is effective in stimulating craving for cocaine. Medications that are eff ective in attenuating this type of ''conditioned'' craving may have re levance to the breaking of the cycle of relapse and the long-term trea tment of cocaine dependence. Diethylpropion may not be an appropriate candidate for future medication development because of its lack of obv ious therapeutic efficacy and the emergence of a significant number of side effects. However, a cocaine-agonist medication strategy may be a ppropriate for a subgroup of cocaine-dependent patients with coexistin g attention deficit-hyperactivity disorder.