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Vigabatrin ineffective in treating cocaine addiction
Vigabatrin did not significantly decrease cocaine use in patients, according to new data published in JAMA Psychiatry.
The researchers said the negative results indicate either the weak efficacy of vigabatrin (Sabril, Lundbeck) or significant nonadherence to the drug.
The 12-week, randomized, double blind, placebo-controlled trial included 186 treatment-seeking participants (mean age, 45 years) with cocaine dependence who were assigned to twice-daily doses of vigabatrin 3 g/day or matched placebo, in addition to weekly computerized cognitive-behavioral therapy sessions and biweekly individual counseling for 13 weeks.
The primary outcome measure was the proportion of patients abstaining from cocaine use during the last 2 weeks of the study period, which was assessed by self-reports and drug screens. The researchers also measured the fraction of participants’ weekly cocaine use and the number of drug-free urine samples.
Vigabatrin is indicated for epilepsy treatment and has been associated with visual field defects.
There were no significant differences observed between the vigabatrin and control groups on the primary (P=.67) or secondary (P>.99) outcome measures. Although pill counts and self-reports indicated that approximately 66% of participants (>63% in the vigabatrin group) took more than 70% of their medication, additional analyses showed that 40% to 60% of participants in the vigabatrin group may not have been adhering to their medication. The researchers observed no visual acuity or visual field deterioration in any of the participants.
An estimated 699,000 patients received treatment for cocaine addiction in 2010, according to background information in the study.
Another trial of vigabatrin, funded by the National Institute on Drug Abuse, is ongoing in several US locations to investigate medication adherence.
Disclosure: See the study for a full list of financial disclosures.