| April 9, 2001
Penn Study Shows That Blood Pressure
Medication May Ease Symptoms of Cocaine Withdrawal
Older medication shows promise in the treatment
of cocaine addiction.
Philadelphia, PA -A medication
long used to treat high blood pressure may ease severe
withdrawal symptoms during the early stages of treatment
for cocaine addiction, offering new hope for patients
unable to wean themselves off cocaine through traditional,
psychotherapeutic counseling.
Scientists at the University of Pennsylvania School
of Medicine and the Department of Veterans Affairs Medical
Center in Philadelphia believe the results of a recent
study show that the medication propranolol may provide
a bridge for cocaine-dependent patients struggling to
get past the first critical weeks of recovery and stay
in treatment.
The results of the propranolol study will be published
in the April 2001 issue of Drug and Alcohol Dependence,
a peer-reviewed journal.
"The drop out rate in cocaine treatment programs
is very high," said Penn's Kyle Kampman, M.D.,
the study's lead researcher. "We found that when
patients who experienced severe withdrawal symptoms
were given propranolol, they tended to stay in treatment
longer and use less cocaine."
Propranolol works to block the anxiety-producing effects
of adrenaline. Those suffering severe withdrawal symptoms
are often more sensitive to adrenaline, which can heighten
anxiety in stressful situations and undermine treatment,
Kampman said.
The findings emerged in an eight-week;
double blind, placebo-controlled trial in which propranolol
was administered to 108 people addicted to cocaine.
Participants in the study, conducted in the fall of
1999, received counseling twice weekly along with regular
doses of propranolol or a placebo. Scientists concluded
that subjects with more severe cocaine withdrawal symptoms
responded better to propranolol in comparison to those
given the placebo.
"The patients who come in with severe withdrawal
symptoms generally are heavier users and are tougher
to treat," said Kampman. "We know from previous
studies that they are more likely to drop out of treatment
programs and are unable to detoxify. Propranolol may
be one way to keep them in treatment longer."
The propranolol investigation was funded through a grant
from the National Institute on Drug Abuse (NIDA).
The study echoes an earlier investigation led by Kampman
into amantadine, a medication used to treat Parkinson's
disease. In that study, researchers found that the medication
may reduce cocaine cravings in patients experiencing
significant withdrawal symptoms.
In the amantadine study, conducted in 1994, 61 cocaine
dependent outpatients participated in a four-week, double
blind, placebo controlled study in which participants
received 100 mg of the medication three times daily.
Results indicated that the craving for cocaine in those
patients who suffered the most intense withdrawal symptoms
diminished when amantadine was administered.
Amantadine is thought to raise dopamine levels in the
brain, reducing the craving for cocaine. The results
of the investigation into amantadine were reported in
the American Journal of Psychiatry in December 2000.
The study was peer-reviewed and supported through a
NIDA grant.
Kampman said a third study exploring the potential benefits
of using propranolol and amantadine in combination or
with other treatment protocols is underway at Penn and
the Department of Veterans Affairs Medical Center in
Philadelphia.
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