Effect of Mirtazapine on Craving in Cocaine-Dependent Patients

Drug craving is the intense desire to consume drugs of abuse that promote compulsive drug use and cause drug relapse, following long-term drug withdrawal. Antidepressants like mirtazapine could be a real alternative therapy to attenuate or prevent cocaine withdrawal symptoms and drug craving. In the present study, we examined the efficacy of mirtazapine on cocaine craving in cocaine-detoxified patients during its maintenance phase. A two-arm randomized, placebo-controlled, double-blind clinical trial was scheduled for a complete 12-week period. A total of 64 cocaine-dependent individuals were randomly allocated into two groups: the placebo group (n = 32) and the mirtazapine (n = 32) groups. Both Cocaine Craving Questionnaire (CCQ-G) and the Symptom Check List 90 (SCL-90-R) were used to assess cocaine craving and the psychopathological status of patients, respectively. Assessments were performed once a week for 12 weeks during the study. Mirtazapine (30 mg/kg) was given daily during the 12 weeks of enduring drug withdrawal. A daily dosing regimen of mirtazapine (30 mg/kg) for 12 weeks significantly decrease the cocaine craving, cocaine use, and some psychiatric symptoms which included depression, anxiety, and mood-negative states along the 12 weeks that endured the study. These data suggest that mirtazapine given to cocaine-dependent patients for 12 weeks of drug withdrawal significantly decreases and controls cocaine-craving behavioral alterations. Furthermore, the present study demonstrates that mirtazapine reduces efficiently some co-morbid psychiatric symptoms that appear during cocaine withdrawal. These results argue in favor of using mirtazapine for treating cocaine addiction, reducing comorbid cocaine-withdrawal symptomology, and relieving drug craving in addicted subjects. Clinical trial number: NCT ID: NCT01949571.