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Tijdschrift voor Psychiatrie 54 (2012) 1, 51 - 58

Review article

Disulfiram as a treatment for cocaine dependency

I. De Mulder, G. Dom

background Cocaine abuse and dependency have a considerable impact on society and health issues. Current treatment of cocaine dependency consists primarily of psychosocial and therapeutic interventions. There is a marked need for effective pharmacological treatments in addition to the currently available treatment options. Recently, there is some evidence that disulfiram (dsf) might reduce use of cocaine in patients presenting with cocaine dependency.
aim To explore the efficacy of disulfiram as a treatment for cocaine dependency.
method We performed a Medline search for randomised controlled trials (rcts) relating to disulfiram as a treatment for cocaine dependency.
results We found six rct’s for this review. Disulfiram seemed to have a positive effect on the primary cocaine outcomes. In addition, a positive effect of disulfiram seemed to be independent of alcohol abuse. However, the quality of these studies was extremely variable both in terms of sample size and composition. A possible neurobiological explanation for this would be an inhibitory effect of disulfiram on dopamine beta-hydroxylase, thus generating lower levels of norepinefrine.
conclusion Disulfiram seems to be a valuable drug for the treatment of cocaine dependency. Due to the limited number and quality of the published studies, further research is needed in order to support the early positive results.

keywords cocaine dependency, disulfiram