Carbamazepine treatment of cocaine dependence in methadone maintenance patients with dual opiate-cocaine addiction.

The cocaine epidemic of the past decade is undermining the efficacy of methadone maintenance (MM) treatment. In an open clinical trial, 12 MM patients addicted to cocaine were offered carbamazepine (CBZ) as a pharmacological adjunct in the treatment of cocaine dependence. Patients reported mild opiate withdrawal symptoms after initiation of CBZ treatment. Methadone serum trough (MST) levels taken before CBZ were compared with levels taken 7-10 days later, with an average decrease in MST levels of 60%. Patients (6) who continued on CBZ (average 144 days) reported a reduction in cocaine use, documented by random urine drug screens. Non-completers (6) who did not continue on CBZ (average 17 days) had no change in cocaine use.