A randomized, double-blind, placebo-controlled trial of citicoline for cocaine dependence in bipolar i disorder

E. Sherwood Brown, Jackie Peterson Todd, Lisa T. Hu, Joy M. Schmitz, Thomas J. Carmody, Alyson Nakamura, Prabha Sunderajan, A. John Rush, Bryon Adinoff, Mary Ellen Bret, Traci Holmes, Alexander Lo

Research output: Contribution to journalArticle

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Abstract

Objective: Although drug dependenceiscommonin patients with bipolar disorder, minimal data are available on the treatment of drug dependence in this patient population. The authors previously reported a decreased risk of relapse to cocaine use in a pilot study of citicoline in patients with bipolar disorder and cocaine dependence. The primary aim of the present study was to determine whether citicoline reduces cocaine use in outpatients with bipolar I disorder and current cocaine dependence and active cocaine use. Method: A total of 130 outpatients with bipolar I disorder (depressed or mixed mood state) and cocaine dependence received citicoline or placebo add-on therapy for 12 weeks. Results of thrice-weekly urine drug screens were analyzed using a generalized linear mixed model that was fitted to the binary outcome of cocaine-positive screens at each measurement occasion for 12 weeks.Moodwas assessed with the Inventory of Depressive Symptomatology?Self Report, the Hamilton Depression Rating Scale, and the Young Mania Rating Scale. Results: In the intent-to-treat sample (N=61 in both groups), significant treatment group and group-by-time effects were observed, whether or not missing urine screens were imputed as cocaine positive. The group effect was greatest early in the study and tended to decline with time. No betweengroup differences in mood symptoms or side effects were observed. Conclusions: Citicoline was well tolerated for treatment of cocainedependence inpatientswithbipolardisorder.Cocaine use was significantly reduced with citicoline initially, although treatment effects diminished over time, suggesting the need for augmentation strategies to optimize long-term benefit.

Original languageEnglish (US)
Pages (from-to)1014-1021
Number of pages8
JournalAmerican Journal of Psychiatry
Volume172
Issue number10
DOIs
StatePublished - Oct 1 2015

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Cytidine Diphosphate Choline
Cocaine-Related Disorders
Bipolar Disorder
Cocaine
Placebos
Outpatients
Urine
Therapeutics
Pharmaceutical Preparations
Self Report
Substance-Related Disorders
Linear Models
Depression
Recurrence
Equipment and Supplies
Population

ASJC Scopus subject areas

  • Psychiatry and Mental health

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A randomized, double-blind, placebo-controlled trial of citicoline for cocaine dependence in bipolar i disorder. / Brown, E. Sherwood; Todd, Jackie Peterson; Hu, Lisa T.; Schmitz, Joy M.; Carmody, Thomas J.; Nakamura, Alyson; Sunderajan, Prabha; Rush, A. John; Adinoff, Bryon; Bret, Mary Ellen; Holmes, Traci; Lo, Alexander.

In: American Journal of Psychiatry, Vol. 172, No. 10, 01.10.2015, p. 1014-1021.

Research output: Contribution to journalArticle

Brown, E. Sherwood ; Todd, Jackie Peterson ; Hu, Lisa T. ; Schmitz, Joy M. ; Carmody, Thomas J. ; Nakamura, Alyson ; Sunderajan, Prabha ; Rush, A. John ; Adinoff, Bryon ; Bret, Mary Ellen ; Holmes, Traci ; Lo, Alexander. / A randomized, double-blind, placebo-controlled trial of citicoline for cocaine dependence in bipolar i disorder. In: American Journal of Psychiatry. 2015 ; Vol. 172, No. 10. pp. 1014-1021.
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AU - Carmody, Thomas J.

AU - Nakamura, Alyson

AU - Sunderajan, Prabha

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AU - Bret, Mary Ellen

AU - Holmes, Traci

AU - Lo, Alexander

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