Pharmacological and behavioral treatments of cocaine dependence: controlled studies.
Pharmacological and behavioral treatments of cocaine dependence: controlled studies.
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发表时间：
1988-02
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通讯作者：
Charles P. O'Brien;Childress Ar;I. Arndt;Mclellan At;G. Woody;I. Maany
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作者：
Charles P. O'Brien;Childress Ar;I. Arndt;Mclellan At;G. Woody;I. Maany
可卡因的流行催生了新的治疗方法，旨在减少这种极其令人上瘾的药物的复发。在戒毒和标准治疗后，前可卡因使用者在面对可卡因相关刺激时继续表现出强烈的可卡因渴望和生理变化。因为这些条件反应可能会增加复发的风险，一种新的治疗方法已经被开发出来来消除这种反应。消失过程，包括可卡因相关刺激的反复呈现，直到刺激逐渐失去其唤起条件反应的能力，被整合到一个全面的康复计划中。可卡因依赖常常与鸦片依赖并存。在美沙酮维持治疗中加入地西帕明，试图减少对这两种物质的依赖。美沙酮阻碍地西帕明的分解代谢，因此相对低剂量的地西帕明可能产生抗抑郁作用，并可能减少使用可卡因的欲望。一项将地西帕明与美沙酮联合使用的安慰剂对照研究的初步证据表明，地西帕明对心理功能有显著改善，但对减少可卡因使用的影响不那么显著。
The cocaine epidemic has stimulated novel treatments aimed at reducing relapse to this extremely addicting drug. After detoxification and standard treatment, former cocaine users continue to exhibit strong cocaine craving and physiological changes when presented with cocaine-related stimuli. Because these conditioned responses may increase the risk of relapse, a new treatment has been developed to extinguish such responses. The extinction process, consisting of repeated presentations of cocaine-related stimuli until the stimuli gradually lose their ability to evoke conditioned responses, is integrated into a comprehensive rehabilitation program. Cocaine dependence is often combined with opiate dependence. Desipramine has been added to methadone maintenance in an attempt to reduce dependence on both substances. Methadone impedes catabolism of desipramine so that relatively low doses of desipramine may produce antidepressant effects and possibly reduce the desire to use cocaine. Preliminary evidence from a placebo-controlled study of desipramine in combination with methadone suggests that desipramine produces significant improvements in psychological functioning, but its effects on reduction of cocaine use are less dramatic.