Venlafaxine Treatment of Cocaine Abusers with Depressive Disorders

• Published in: The American journal of drug and alcohol abuse 2000-01, Vol.26 (1), p.25-31
• Main Authors: McDowell, David M., Levin, Frances R., Seracini, Angela M., Nunes, Edward V.
• Format: Article
• Language: English
• Subjects: Adult; Antidepressive Agents, Second-Generation - adverse effects; Antidepressive Agents, Second-Generation - therapeutic use; Biological and medical sciences; Cocaine; Cocaine-Related Disorders - psychology; Cocaine-Related Disorders - rehabilitation; Comorbidity; Cyclohexanols - adverse effects; Cyclohexanols - therapeutic use; Depressive Disorder, Major - psychology; Depressive Disorder, Major - rehabilitation; Desipramine - adverse effects; Desipramine - therapeutic use; Diagnosis, Dual (Psychiatry); Double-Blind Method; Drug abuse; Female; Humans; Male; Medical sciences; Mental depression; Middle Aged; Neuropharmacology; Pharmacology. Drug treatments; Pilot Projects; Prescription drugs; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopharmacology; Treatment Failure; Venlafaxine Hydrochloride
• ISSN: 0095-2990; 1097-9891
• DOI: 10.1081/ADA-100100588

Objective: There appears to be a link between depression and cocaine that is both complex and elusive. The purpose of this study was to examine the effect of venlafaxine, a broad spectrum antidepressant, in the treatment of 13 patients who were diagnosed with cocaine dependence and comorbid major depressive disorder (MDD). Method: The majority of the patients in the study were part of a larger double-blind trial using desipramine. This subgroup consisted of people who had failed to respond to desipramine or could not tolerate its side effects. Thirteen patients were enrolled, 10 men and 3 women. Of the patients, 11 completed the 12-week study. All of the patients had a Hamilton Depression (HAM-D) score greater than 14 at baseline, and each had used at least $20 worth of cocaine per week in the 4 weeks prior to entering the study. In addition, all of the patients received weekly relapse prevention therapy throughout the study. The median dose of venlafaxine was 150 mg day. Results: The 11 patients who completed the study had significant reductions in mood symptoms by the end of the study. The average total HAM-D score at baseline was 18.0 ± 3.2; at Week 2, it was 1.9 ± 0.94; and at the end of the study, it was 1.4 ± 1.8. The majority of patients reported reductions of cocaine use short of abstinence. All subjects reported a greater than 75% reduction in cocaine use compared to baseline. There were no serious side effects. Conclusions: The results of this small study indicate that venlafaxine may be a safe, well-tolerated, rapidly acting, and effective treatment for patients with a dual diagnosis of depression and cocaine dependence.