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Bupropion Reduces Cocaine Abuse in Methadone-Maintained Patients

Arthur Margolin, Phd; Thomas Kosten, MD; Ismene Petrakis, MD; S. Kelly Avants, MS; Therese Kosten, Phd
Arch Gen Psychiatry. 1991;48(1):87. doi:10.1001/archpsyc.1991.01810250089015.
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To the Editor.—  Cocaine abuse is a major problem among methadonemaintained patients.1 We recently tested the "second generation" antidepressant bupropion with six cocaine-dependent, methadone-maintained patients in an 8-week open pilot study. A test of the drug for the treatment of cocaine dependence was suggested by research showing that it directly influences dopaminergic transmission2 and because it possesses few of the cardiovascular and anticholinergic side effects of "first generation" antidepressants.3

Patients and Methods.—  Six methadonemaintained patients participated in the study (two males and four females; mean [±SD] age, 35 ±11 years; daily mean [±SD] methadone dosage, 60 ±20 mg). All subjects were chronic intravenous cocaine users (mean [ ± SD] years of cocaine use, 12 ±8.2 years) who had used at least 0.5 g of cocaine per week for 3 months previous to entry into the study. All met DSM-III-R criteria for cocaine dependence. Subjects received 100 mg


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