Modafinil Treatment of Cocaine Dependence: A Systematic Review and Meta-Analysis

@article{Sangroula2017ModafinilTO,  title={Modafinil Treatment of Cocaine Dependence: A Systematic Review and Meta-Analysis},  author={Dinesh Sangroula and Fatima Bilal Motiwala and Bivek Wagle and Vivek C Shah and Katsuhiko Hagi and Steven B. Lippmann},  journal={Substance Use \& Misuse},  year={2017},  volume={52},  pages={1292 - 1306},  url={https://api.semanticscholar.org/CorpusID:4775658}}
Overall, there is no evidence to conclude superiority of modafinil in increasing cocaine abstinence and treatment retention rate, but promising result in subgroup analysis of cocaine abstinence, secondary outcomes, and good safety profile urged the need of larger studies to derive more conclusive results.

29 Citations

Pharmacotherapeutic Strategies for Treating Cocaine Use Disorder - What Do We Have to Offer?

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This meta-analysis is unique in its broad inclusivity of treatment types and trial designs over a two-decade period of investigation and convergence with focused meta-analyses on treatments for cocaine use disorders.

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The current literature does not strongly support any individual MAT for CUD, but it is worth seriously considering MAT for patients who do not respond well to psychosocial interventions alone given limitations in access to care.

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Modafinil has a better effect on subjects with low baseline level of cocaine craving, withdraw symptom and light alcohol use than placebo on lowering the weekly cocaine abstinence rate.

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There was sufficient evidence to support the efficacy of contingency management programs for treatment of stimulant use disorder, but psychostimulants, n-acetylcysteine, opioid agonist therapy, disulfiram and antidepressant pharmacological interventions were found to have insufficient evidence tosupport or discount their use.

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Modafinil, a DAT inhibitor approved for use in the treatment of narcolepsy and sleep disorders, has shown promise in the Treatment of PSUD among specific populations of affected individuals and is highlighted for the lack of sex differences in the actions of these agents.

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It is plausible that by identifying moderating factors impacting cognition, behavioral interventions can be modified accordingly and/or treatment regimens can be augmented with pharmacological interventions, leading to a reduction in treatment attrition and improved treatment outcomes.

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Modafinil is a nonamphetamine nootropic drug with an increasingly therapeutic interest due to its different sites of action and behavioral effects in comparison to cocaine or amphetamine, and its psychotropic and cognitive effects are also attractive in several other pathologies and conditions that affect sleep structure, induce fatigue and lethargy, and impair cognitive abilities.

Glutamatergic Agents for the Treatment of Cocaine Use Disorder

It is suggested that beta-lactam antibiotics, propentofylline, metabotropic glutamate-receptor-5 antagonists, and ketamine may alter neuroplastic processes related to chronic cocaine use.

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