Preliminary investigation of the administration of biperiden to reduce relapses in individuals with cocaine/crack user disorder: A randomized controlled clinical trial

• Published in: Pharmacology, biochemistry and behavior biochemistry and behavior, 2024-04, Vol.237, p.173725, Article 173725
• Main Authors: Junior, Miguel Siqueira Campos, Bezerra, Andréia Gomes, Curado, Daniela Fernández, Gregório, Renata Pauluci, Galduróz, José Carlos Fernandes
• Format: Article
• Language: English
• Subjects: Biperiden; Biperiden - pharmacology; Biperiden - therapeutic use; Cholinergic antagonist; Cocaine-Related Disorders - drug therapy; Crack cocaine; Crack Cocaine - adverse effects; Craving; Double-Blind Method; Humans; Muscarinic Antagonists - pharmacology; Muscarinic Antagonists - therapeutic use; Receptor, Muscarinic M1
• ISSN: 0091-3057; 1873-5177; 1873-5177
• DOI: 10.1016/j.pbb.2024.173725

Several studies have demonstrated that ACh modulates the dopaminergic circuit in the nucleus accumbens, and its blockade appears to be associated with the inhibition of the reinforced effect or the increase in dopamine caused by cocaine use. The objective of this study was to evaluate the effect of biperiden (a muscarinic receptor antagonist with a relatively higher affinity for the M1 receptor) on crack/cocaine use relapse compared to a control group that received placebo. This study is a double-blind, randomized, placebo-controlled clinical trial. The intervention group received 2 mg of biperiden, 3 times a day, for a period of 3 months. The control group received identical placebo capsules, at the same frequency and over the same period. All participants were followed for a period of six months. The sample comprised 128 people, with 61 in the control group and 67 in the biperiden group. Lower substance consumption was observed in the group that received biperiden treatment two (bT2 = −2.2 [−3.3; −1.0], p