Antidepressants
Dopamine agonists
Dopamine antagonists
Disulfiram
CNS stimulants
Vaccines
Calcium blockers
Opioid agonists and antagonists
Alternative therapies
Antidepressants
Key points:- Transition to injecting can be prevented with CBT intervention.
Strength of evidence: 1 star
- There is no current evidence supporting the clinical use of antidepressants in the treatment of cocaine dependence.
Strength of evidence: 3 stars
- Antidepressants have very limited benefits in the treatment of amphetamine dependence.
Strength of evidence: 3 stars
- Antidepressants may be suitable in cases of concomitant cocaine dependence and depression.
Strength of evidence: ?
Dopamine agonists
Key points:- There is no current evidence supporting the clinical use of dopamine agonists in the treatment of cocaine dependence.
Strength of evidence: 3 stars
Dopamine antagonists
Key points:- There is no current evidence supporting clinical use of carbamazepine in the treatment of cocaine dependence.
Strength of evidence: 3 stars
- Phenytoin may be more effective than placebo in reducing cocaine use.
Strength of evidence: 2 stars
- Flupenthixol, haloperidol and risperidone are probably not useful due to side-effects.
Strength of evidence: 3 stars
Disulfiram
Key points:- Disulfiram as an adjunct to buprenorphine or methadone maintenance may reduce cocaine use in opioid-dependent people.
Strength of evidence: 3 stars
CNS stimulants
Key points:- Prescription of oral amphetamines is of potential value as a substitution treatment for dependent, injecting amphetamine users.
Strength of evidence: 2 stars
- Methylphenidate is not generally effective in reducing cocaine use.
Strength of evidence: 3 stars
- Dexamphetamine may be of value in reducing cocaine use.
Strength of evidence: 2 stars
Vaccines
Key points:- Cocaine vaccines may provide therapeutic support by reducing the psychoactive effect of cocaine.
Strength of evidence: ?
Calcium blockers
Key points:- Calcium blockers may, or may not, have therapeutic effect.
Strength of evidence: ?
Opioid agonists and antagonists
Key points:- Combined behavioural and pharmacological treatment for cocaine users who are also opioid dependent may reduce cocaine use.
Strength of evidence: 2 stars
- Buprenorphine is no more effective than methadone in reducing cocaine use amongst opioid dependent clients.
Strength of evidence: 3 stars
Alternative therapies
Key points:- Auricular acupuncture does not appear to significantly reduce cocaine use.
Strength of evidence: 2 stars