A double-blind, placebo-controlled assessment of the safety of potential interactions between intravenous cocaine, ethanol, and oral disulfiram.

Aún no traducido Aún no traducido
Categoría Estudio primario
RevistaDrug and alcohol dependence
Año 2011

Este artículo está incluido en 1 Revisión sistemática Revisiones sistemáticas (1 referencia)

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BACKGROUND:

A majority of cocaine addicts have a comorbid alcohol use disorder. Previous studies demonstrated efficacy of disulfiram in the treatment of cocaine dependence among patients with comorbid alcohol use disorder or opioid dependence. However, the cardiac risks of a disulfiram–ethanol reaction (DER) in individuals who drink, when coupled with the cardiac effects of cocaine, could result in significant toxicity or lethality due to the 3-way drug interaction.

AIMS:

This study examined the safety of combining cocaine (30mg i.v.) and ethanol (0.4g/kg i.v.) in disulfiram-treated (0, 250, and 500mg/d, p.o.) cocaine-dependent research volunteers.

RESULTS:

The results showed that disulfiram did not enhance the cardiovascular effects of cocaine and may have reduced the subjective high from cocaine. In contrast, ethanol produced adverse ECG changes including QTc prolongation and a DER consisting of hypotension, tachycardia, nausea, and flushing in disulfiram-treated subjects. The severity of the DER was related to disulfiram dose and the trial with 500mg/d was stopped prematurely due to safety concerns. The DER-related hypotension and tachycardia seen with ethanol infusion alone in disulfiram-treated subjects, was not exacerbated when combined with cocaine. In fact, cocaine tended to counteract the ethanol-related hypotension though it did exacerbate the tachycardia in two of seven subjects.

CONCLUSIONS:

Though conclusions are limited by the moderate doses of cocaine, ethanol, and disulfiram tested, the data do suggest that the risks of the moderate use of cocaine and ethanol in individuals treated with moderate doses of disulfiram (≤250mg/d) may not be as problematic as some may assume. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
Epistemonikos ID: fb22d63fd24c43e1908a9a935ab05cc497710d60
First added on: Nov 27, 2016