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Randomized Controlled Trial
. 2012 Mar;38(2):181-6.
doi: 10.3109/00952990.2011.644002. Epub 2012 Jan 5.

The efficacy of mirtazapine in the treatment of cocaine dependence with comorbid depression

Maryam Afshar  1 , Clifford M Knapp, Ofra Sarid-Segal, Eric Devine, Laurie Sickles Colaneri, Lisa Tozier, Megan E Waters, Megan A Putnam, Domenic A Ciraulo
Affiliations
Randomized Controlled Trial

The efficacy of mirtazapine in the treatment of cocaine dependence with comorbid depression

Maryam Afshar et al. Am J Drug Alcohol Abuse. 2012 Mar.

Abstract

Background: Prior findings concerning the use of mirtazapine in the treatment of a variety of substance use disorders and its antagonistic actions at the serotonin 5-HT(2A) receptor suggest that this drug may have efficacy in the treatment of cocaine dependence in the presence of a depressive disorder.

Methods: Depressed cocaine-dependent subjects received either mirtazapine (target dose 45 mg daily) or placebo for 12 weeks. Urine concentrations of benzoylecgonine and self-report were used to assess cocaine consumption. Depression and sleep quality were evaluated using the Hamilton Depression Rating Scale (HAM-D) and the Pittsburgh Sleep Quality Index, respectively.

Results: Cocaine consumption during the treatment period did not differ significantly between the mirtazapine (n = 11) and placebo (n = 13) groups in this study. In week 4 sleep latency was significantly lower in the active medication than in the placebo group. Positive effects of mirtazapine treatment on early insomnia were suggested by an item analysis of the HAM-D.

Conclusions and scientific significance: The results of this study suggest that mirtazapine is superior to placebo in improving sleep in patients with comorbid depression and cocaine dependence, but is not more effective than placebo in reducing cocaine use.

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Conflict of interest statement

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Figures

Figure 1
Figure 1
Mean (±SE) ln benzoylecgonine (BE) concentrations obtained for the screening period (week 0) and the treatment period (weeks 1–11) for the mirtazapine (MIRTZ) and placebo (PLAC) groups.
Figure 2
Figure 2
Mean (SE) sleep latency obtained for the mirtazapine (MIRTZ) and placebo (PLAC) groups at screening and weeks 4, 8, and 12. *p < .008 for the between group comparison.
See this image and copyright information in PMC

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