Int Conf AIDS. 1992 Jul 19-24;8(3):53 (abstract no. PuB 7028). Unique
OBJECTIVE: To test the effectiveness of fluoxetine treatment of cocaine
abuse in HIV-infected injection drug users (IDUs) in methadone
maintenance treatment (MMT). METHOD: In a randomized, double-blind,
twelve week trial of fluoxetine for the treatment of cocaine dependence,
an interim analysis was done of the first 23 HIV-infected subjects in
this study. Fifteen (65%) were African-American and 12 (52%) were male.
Mean age was 38 years. Eleven (48%) had a current diagnosis of Major
Depressive Disorder. Sixteen (70%) patients were on AZT during the
twelve weeks of treatment. Fluoxetine was given in doses of up to 40 mg.
per day. RESULTS: Fluoxetine appeared to be well tolerated. Of 23
patients, 16 completed the 12 week study. The fluoxetine (FLX) group
showed differences in self-reported cocaine use and cocaine craving
during the study. Mean days of cocaine use for weeks 3-12 was 1.2
days/wk (FLX) compared to 2.5 days/wk (PLA) (unpaired t-test p = .10).
Mean weekly craving scores for weeks 3-12 was 4.1 (FLX) compared to 6.8
(PLA) (possible range 0-24) (p = 0.07). Urine benzoylecgonine (BE)
levels showed no significant differences between the two groups in this
analysis: log of mean urine BE ng/ml, for weeks 3-12, was 4.3 (FLX) and
4.4 (PLA) (NS). Beck Depression Inventory and Ham-D scores both
decreased significantly from intake to week 12 in the FLX but not in the
PLA group (paired t-test p less than .01). CD4 lymphocyte counts were
obtained before and after the twelve weeks of treatment. Mean CD4 (FLX)
was 455 at intake and 488 at week 12, while mean CD4 (PLA) decreased
from 415 at intake to 361 at week 12 (NS). CONCLUSION: Fluoxetine is
well-tolerated and may be useful in reducing cocaine abuse and
depression in HIV-infected IDUs in MMT.
Adult *Cocaine Depressive Disorder/COMPLICATIONS/*DRUG THERAPY
Double-Blind Method Female Fluoxetine/*THERAPEUTIC USE Human HIV
Infections/*COMPLICATIONS Male Substance
Dependence/COMPLICATIONS/*DRUG THERAPY ABSTRACT