Provigil (Modafinil) Plus Cognitive Behavioral Therapy for Methamphetamine Use in HIV+ Gay Men: A Pilot Study

• Published in: The American journal of drug and alcohol abuse Vol. 35; no. 1; pp. 34 - 37
• Main Authors: McElhiney, Martin C., Rabkin, Judith G., Rabkin, Richard, Nunes, Edward V.
• Format: Journal Article
• Language: English
• Published: Colchester Informa UK Ltd 2009; Taylor & Francis; Taylor & Francis Ltd
• Subjects: Addictive behaviors; Adult; Adult and adolescent clinical studies; Behavior Therapy; Behavior therapy. Cognitive therapy; Benzhydryl Compounds - therapeutic use; Biological and medical sciences; Clinical trials; Cognitive behavioral therapy; Cognitive behaviour therapy; Cognitive therapy; Combined Modality Therapy; Drug addiction; drug dependence; Drug use; Gays & lesbians; HIV; HIV Infections - complications; HIV/AIDS; Homosexuality; Homosexuals; Human immunodeficiency virus; Humans; Male; Medical sciences; Men; Methamphetamine; Methamphetamine - adverse effects; methamphetamine abuse; Modafinil; Neuropharmacology; New York City; Pharmacology. Drug treatments; Pilot Projects; Placebos; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer; Psychoanaleptics: cns stimulant, antidepressant agent, nootropic agent, mood stabilizer..., (alzheimer disease); Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychopharmacology; Side effects; Single-Blind Method; Substance abuse treatment; Substance-Related Disorders - complications; Substance-Related Disorders - drug therapy; Substance-Related Disorders - psychology; Substance-Related Disorders - rehabilitation; Treatments; New York City; Amphetamine derivatives; Homosexuality; Psychotropic; Metamfetamine; Cognitive behavioral therapy; Behavior therapy; HIV/ AIDS; Human; Immunopathology; Drug addiction; Cognitive therapy; Abuse; CNS stimulant; Illicit drug; Use; AIDS; Sympathomimetic; Immune deficiency; drug dependence; Infection; methamphetamine abuse; Treatment; Addiction; Modafinil; Viral disease
• ISSN: 0095-2990; 1097-9891
• DOI: 10.1080/00952990802342907

Objectives: To evaluate the efficacy of modafinil combined with cognitive behavioral therapy (CBT) for treatment of methamphetamine (MA) dependence among HIV+ gay men. Methods: In a single blind trial, modafinil was administered for 12 weeks, followed by a 4-week placebo phase. CBT was conducted for 18 sessions over the 16-week study. Primary outcome measures were self-reported use of days per week plus urine toxicology assays. Additional measures included the Beck Depression Inventory, Cravings Scale, and O/C Crystal Use Scale. Response was defined as > 50% decline in days used per week. Thirteen patients were enrolled over an 18-month period. Results: Ten patients (77%) completed the trial, although two discontinued modafinil due to side effects. Six of the ten study completers reduced their MA use by > 50%. Conclusions: These preliminary results suggest good retention using combined medication and psychotherapy, and support further examination of modafinil and CBT in double-blind placebo controlled trials.