Effects of biperiden on the treatment of cocaine/crack addiction: A randomised, double-blind, placebo-controlled trial

Effects of biperiden on the treatment of cocaine/crack addiction: A randomised, double-blind, placebo-controlled trial

Author Junqueira Dieckmann, Luiz Henrique Autor UNIFESP Google Scholar
Ramos, Anna Carolina Autor UNIFESP Google Scholar
Silva, Eroy Aparecida Autor UNIFESP Google Scholar
Justo, Luis Pereira Autor UNIFESP Google Scholar
Sabioni, Pamela Autor UNIFESP Google Scholar
Frade, Iracema Francisco Autor UNIFESP Google Scholar
Souza, Altay Lino de Autor UNIFESP Google Scholar
Fernandes Galduroz, Jose Carlos Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Cocaine use affects approximately 13.4 million people, or 0.3% of the world's population between 15 and 64 years of age. Several authors have described drug addiction as a disease of the brain reward system. Given that the cholinergic system impacts reward mechanisms and drug self-administration, acetylcholine (ACh) might play an important role in the cocaine addiction process. We evaluated the efficacy of biperiden (a cholinergic antagonist) in reducing craving and the amount used, and in increasing compliance with treatment for cocaine/crack addiction. It was a study double-blind, randomised, placebo-controlled, 8-week trial of 111 cocaine or crack addicted male patients between 18 and 50 years old. Two groups were compared: placebo (n=55) or biperiden (n=56) combined with weekly sessions of brief group cognitive-behavioural therapy. the efficacy of treatment was evaluated according to the patients' compliance and several instruments: the Minnesota Cocaine Craving Scale, the Beck Depression and Anxiety Scales and a questionnaire assessing the amount of drug used. All of the patients attended weekly sessions for two months. We analysed the data considering the patients' intention to treat based on our last observation. of the 56 patients in the biperiden group, 24 completed the treatment (42.8%) compared with only 11 patients in the placebo group (20%), which was a significant difference (p=0.009). Compliance with treatment was 118% higher in the biperiden group, which was also the group that presented a statistically significant reduction in the amount of cocaine/crack use (p<0.001). There was statistically significant difference between the craving score in the biperiden group. Pharmacological blockade of the cholinergic system with biperiden is a promising alternative to treat cocaine/crack addiction, helping patients to reduce the amount used and improving compliance with psychotherapy treatment. (C) 2014 Elsevier B.V. and ECNP. All rights reserved.
Keywords Cocaine
Crack
Biperiden
Cholinergic antagonist
Treatment
Craving
Language English
Sponsor AFIP
Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)
Grant number CNPq: 402657/2010-1
Date 2014-08-01
Published in European Neuropsychopharmacology. Amsterdam: Elsevier B.V., v. 24, n. 8, p. 1196-1202, 2014.
ISSN 0924-977X (Sherpa/Romeo, impact factor)
Publisher Elsevier B.V.
Extent 1196-1202
Origin http://dx.doi.org/10.1016/j.euroneuro.2014.06.001
Access rights Closed access
Type Article
Web of Science ID WOS:000340990100003
URI http://repositorio.unifesp.br/handle/11600/38047

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