Effectiveness of propranolol for cocaine dependence treatment may depend on cocaine withdrawal symptom severity

Propranolol may reduce symptoms of autonomic arousal associated with early cocaine abstinence and improve treatment outcome. This trial was an 8-week, double-blind, placebo-controlled trial of propranolol in 108 cocaine depen dent subjects. The primary outcome measure was quantitative urinary benzoyl ecgonine levels. Secondary outcome measures included treatment retention, a ddiction severity index results, cocaine craving, mood and anxiety symptoms , cocaine withdrawal symptoms. and adverse events. Propranolol treated subj ects had lower cocaine withdrawal symptom severity but otherwise did not di ffer from placebo treated subjects in any outcome measure. However, in a se condary, exploratory analysis, subjects with more severe cocaine withdrawal symptoms responded better to propranolol in comparison to placebo. In thes e subjects, propranolol treatment was associated with better treatment rete ntion and lower urinary benzoylecgonine levels as compared with the placebo treatment. Propranolol may be useful only for the treatment of cocaine dep endent patients with severe cocaine withdrawal symptoms. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.