Tim Brunson DCH

Welcome to The International Hypnosis Research Institute Web site. Our intention is to support and promote the further worldwide integration of comprehensive evidence-based research and clinical hypnotherapy with mainstream mental health, medicine, and coaching. We do so by disseminating, supporting, and conducting research, providing professional level education, advocating increased level of practitioner competency, and supporting the viability and success of clinical practitioners. Although currently over 80% of our membership is comprised of mental health practitioners, we fully recognize the role, support, involvement, and needs of those in the medical and coaching fields. This site is not intended as a source of medical or psychological advice. Tim Brunson, PhD

Comparison of most effective strategies among cocaine-dependent patients

Researchers from the Department of Psychiatry at Yale University School of Medicine compared the effectiveness of disulfiram (Antabuse) with placebo medication as well as against Cognitive Behavioral Therapy (CBT) and Interpersonal Psychotherapy (IPT) in reducing cocaine use in a randomized, placebo-controlled, double blinded (regarding the meds) design.

At a community-based, outpatient, substance abuse treatment program, 121 patients meeting the criteria for current cocaine dependence were randomly assigned to four treatment conditions: disulfiram (Antabuse) plus CBT, disulfiram plus IPT, placebo plus CBT, and placebo plus IPT.

Patients received either disulfiram (250 mg/d) or placebo in identical capsules. Medication compliance was monitored using a riboflavin marker procedure. Both behavioral therapies (CBT and IPT) were manual-guided and were delivered in individual sessions for 12 weeks. Outcomes were measured through random regression analyses of self-reported frequency of cocaine use and results of urine toxicology screens.

The study found that participants assigned to disulfiram reduced their cocaine use significantly more than those assigned to placebo, and those assigned to CBT reduced their cocaine use significantly more than those assigned to IPT (P<.01 for both). Findings were consistent across all study samples (eg, intention to treat, treatment initiators, and treatment completers).

Benefits of disulfiram use and CBT were most pronounced in participants who were not alcohol dependent at baseline or who fully abstained from drinking alcohol during treatment. Adverse effects experienced by participants who received disulfiram were mild and were not considerably different from those experienced by participants who received placebo.

The study concludes that Disulfiram and CBT are effective therapies for general populations of cocaine-dependent individuals. Disulfiram seems to exert a direct effect on cocaine use rather than through reducing concurrent alcohol use.

Citation: Carroll KM, Fenton LR, Ball SA, Nich C, Frankforter TL, Shi J, Rounsaville BJ. Efficacy of disulfiram and cognitive behavior therapy in cocaine-dependent outpatients: a randomized placebo-controlled trial. Arch Gen Psychiatry. 2004 Mar;61(3):264-72. kathleen.carroll@yale.edu

There are no trackbacks for this entry.

Trackback URL for this entry:

© 2000 - 2023The International Hypnosis Research Institute, All Rights Reserved.