Cocaine use disorders affect approximately 1.5 million Americans annually. Currently, there are no US Food and Drug Administration approved medications for treatment of cocaine dependence; however, both animal and human studies suggest that medications affecting the noradrenergic system can reduce cocaine craving and use. The investigators will study the effect of doxazosin, an alpha-1 adrenergic antagonist, in reducing cocaine use and anxiety symptoms among cocaine-dependent individuals. In addition, the investigators will identify genetic subpopulations of participants who preferentially respond to the medication.
Name: Doxazosin
Description: Doxazosin is initiated at 2 mg/wk, and titrated up to a maximum of 8 mg/day over approximately 4 weeks. Participants will be maintained on 8mg daily dosing until week 13. The subjects will undergo the discontinuation from the study medication during weeks 14 -15.Type: DrugDoxazosin
Name: Placebo
Description: Matched placebo daily dosingType: DrugPlacebo
Description: Reduction in cocaine use and abstinence rates as assessed by thrice-weekly urine drug screen and self-report
Measure: Reduction in cocaine use Time: Up to 13 weeks, or for the duration of the participant's involvement in the studyDescription: Weeks in treatment
Measure: Treatment Retention Time: Up to 13 weeks, or for the duration of the participant's involvement in the studyDescription: Reported medication side effects (medication tolerability)
Measure: Adverse events Time: Up to 13 weeks, or for the duration of the participant's involvement in the studyDescription: Self-report of level of craving using visual analog scale (VAS)
Measure: Changes in cocaine craving Time: Up to 13 weeks, or for the duration of the participant's involvement in the studyAllocation: Randomized
Parallel Assignment
There is one SNP
Additionally, this study will identify genetic subpopulations of participants for whom doxazosin is preferentially effective, specifically examining the R492C functional polymorphism of the ADRA1A gene. --- R492C ---