A RANDOMIZED TRIAL OF BROMOCRIPTINE FOR COCAINE USERS PRESENTING TO THE EMERGENCY DEPARTMENT

Objective: To determine the practicality of treating heavy cocaine users with bromocriptine in an outpatient setting to reduce cocaine use and increase entry into drug treatment. Design: Double-blind, randomized, placebo-controlled trial. Setting: VA Medical Center emergency department. Participants: Twenty-nine men presenting for minor medical complaints who used cocaine at least four times per week for the previous month. Intervention: Subjects received either bromocriptine, 1.25 mg, or placebo three times per day for two weeks. Measurements and main results: On three follow-up visits, subjects were tested for cocaine metabolites and surveyed about their drug use and symptoms. Eight of 14 subjects randomized to the bromocriptine group appeared for follow-up evaluation and seven enrolled in drug treatment. Three of these patients tested negative for cocaine at all three visits. Ten of 15 control patients appeared for follow-up visits and five enrolled in drug treatment. None of the control patients tested negative for cocaine for all three visits. There was no major side effect. Conclusion: Bromocriptine can be administered safely to heavy cocaine users in an emergency department setting. The question of whether bromocriptine will reduce the use of cocaine or promote entry into drug treatment deserves further research.