EFFECTS OF COMBINED FLUOXETINE AND COUNSELING IN THE OUTPATIENT TREATMENT OF COCAINE ABUSERS

Three methods of analysis were used to determine the effects of the co mbination of counseling with fluoxetine (20, 40, or 60 mg) and ''activ e'' placebo (diphenhydramine, 12.5 mg) randomly assigned. Forty-five c ocaine-only dependent subjects were treated as outpatients with ''inte rpersonal'' counseling, medication, and drug use monitoring three time s per week for up to 12 weeks. Treatment effects were analyzed: first, by comparing the three original assignments and placebo; second, by c omparing the placebo group to fluoxetine subjects with detectable fluo xetine/norfluoxetine blood levels and those with no detectable medicat ion blood level; third, by examining relapse prevention versus use ces sation through stratifying the subjects into four groups according to fluoxetine or placebo assignment and initial urine cocaine positivity or negativity. All three analyses showed improvement on some measures over time regardless of group assignment. The 60-mg fluoxetine group s howed least effectiveness, the group with detectable blood levels had less cravings, and the fluoxetine subjects who were abstinent at the s tart of treatment were somewhat less likely to avoid relapse than thos e on placebo.