Saturday, November 23, 2013

Effects of Modafinil in a novel model of relapse to cocaine use - Richard Foltin - ISAM 2013 - Kuala Lumpur

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Taking individuals who report heavy cocaine use and urine tests supports and we give them cocaine and study them . There is not a treatment component.
Binge pattern of use - we model effect - done periods of hours to days,
On average our guys 3-4 x a week, and spend $300 to $400 a week
We let people use a lot of drugs. Like they did on street in short period of time.  In other studies had used just one dose.
We did a study on Modafanil and showed it significantly reduced cocaine craving
Modafinil also shown to reduce the amount of money people were willing to pay.
Cost $5 to smoke cocaine,  We have them buy dose  of cocaine like on street from money earned in study.
Modelling relapse behaviour in the laboratory.
Playing game of bingo got money.  Had pressing computer bar 4000 to get does of cocaine.  In crease of the cost of cocaine and work didn't reduce the number of dose.
To look at relapse - gave free dose and there was a little increase
Modafinil given for 5 days.  This decreased cocaine use by about 1 dose - they were dosing 4to 6 time.
Modafinil didn't decrease cocaine use when it was cheap but it did when the cocaine was more expensive.  The effects are modest.
Modafinil can be used patients on Methadone
Pretty safe medication
If you drink alcohol modafinil doesn't work as all

 (These are my rough notes. I apologize for any errors. It was a deep discussion of a remarkable and elegant research design.  I was very impressed by the ingenuity of the researchers in setting up laboratory equivalents of the contextual reality of street cocaine use.  There is definitely a place for modafinil in the armamentium of addiction medicine. Another useful tool in the toolbox.)

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