In the study, 121 cocaine-dependent individuals received disulfiram, also known as Antabuse, or a placebo. They also underwent cognitive behavioral therapy (CBT) or interpersonal psychotherapy (IPT) in individual sessions during the 12-week project.

Results showed that participants given disulfiram reduced their cocaine use significantly compared with people given placebo. Also, those who received disulfiram in combination with CBT reduced their cocaine use compared with those who received disulfiram in combination with IPT.

Lead investigator Dr. Kathleen Carroll, of Yale University School of Medicine, and her colleagues reported that benefits seen with disulfiram and CBT were most pronounced for people who were not alcohol dependent or who abstained fully from alcohol during therapy.

"About 60 percent of people dependent on cocaine also abuse alcohol, so it was thought you could reduce cocaine abuse by targeting the accompanying codependence on alcohol," says NIDA Director Dr. Nora D. Volkow. "But these results suggest that disulfiram exerts a direct effect on cocaine use, rather than reducing concurrent alcohol use. More research is needed about whether combining disulfiram with CBT provides an even more effective tool for treating cocaine dependence."

Disulfiram is one of two medications approved by the Food and Drug Administration (FDA) for treating alcohol abuse. It interferes with the metabolism of alcohol, producing aversive reactions such as nausea and vomiting when alcohol is ingested. The FDA notes that aversive reactions may also occur when patients taking disulfiram use cocaine.

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