Cocaine abuse continues to be epidemic, and yet there are no FDA approved medications for the treatment of cocaine use disorders. A previous pilot study conducted by this author suggested that quetiapine may help reduce the cravings for cocaine in 22 individuals with cocaine dependence.

This 12-week, prospective, intent-to-treat, double-blind, randomized, placebo-controlled study examined the effectiveness of quetiapine (Seroquel SR™) versus matched placebo for the treatment of cocaine dependence in non-psychotic individuals. Sixty individuals with a diagnosis of cocaine dependence were randomized in this study, 29 into the quetiapine arm, and 31 into the placebo arm. Those who were randomized to quetiapine were titrated up to a target dose of 400 mg/day of quetiapine, while those on the placebo arm were given a matched placebo. All subjects had weekly clinic visits for a cognitive-behavioral therapy group session. Outcome measures included questionnaires of cocaine use, cravings for cocaine, and urine drug screen.

Initial analyses indicate that the intensity, frequency, and length of cocaine cravings were reduced over 6 weeks in both the quetiapine and placebo groups. All hazard analyses indicated that the total money spent on cocaine also decreased in both groups, with a trend toward greater decrements in cocaine use the longer they remained in the study. Data analyses are ongoing to determine the potential effect of quetiapine on treatment of cocaine addiction.

Conclusions regarding the use of quetiapine as a treatment for cocaine dependence will be discussed.