Evidence map›Paper›PMID 42483790›Full record

SynthesisAddiction (Abingdon, England)2026

Efficacy and safety of pharmacological interventions for the treatment of cocaine use disorder: A systematic review and network meta-analysis.

Craig Paterson, Thomas Parkhouse, Chloe Burke, Monika Halicka, Jennifer C Palmer, Hend Gabr, Rebecca Wilson, Katie E Webster, Francesca Spiga, Sarah Dawson and 4 more

Abstract readSystematic ReviewNetwork Meta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Addiction (Abingdon, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Craig PatersonPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.ORCID https://orcid.org/0000-0003-3125-9712
Thomas ParkhousePopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Chloe BurkePopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Monika HalickaPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.ORCID https://orcid.org/0000-0001-6283-9352
Jennifer C PalmerPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Hend GabrPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.ORCID https://orcid.org/0000-0002-4991-2911
Rebecca WilsonPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Katie E WebsterPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Francesca SpigaPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Sarah DawsonPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Deborah M CaldwellPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Jennifer ScottPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
Julian P T HigginsPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.ORCID https://orcid.org/0000-0002-8323-2514
Jelena SavovićPopulation Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.

Funding

National Institute for Health and Care Research NIHR165378
6 · The paper itself

Abstract

BACKGROUND AND

aimsCocaine use disorder (CUD) is an increasingly widespread concern worldwide. Various pharmacological treatments have been investigated for CUD, but their efficacy remains unclear, and none have been licensed for treatment. Therefore, we assessed the comparative effectiveness, safety and acceptability of pharmacological interventions for the treatment of CUD and prevention of relapse.

methodsSystematic review and network meta-analyses (PROSPERO: CRD42024596434) of double-blind randomized controlled trials (RCTs) of pharmacological interventions specifically tested for the treatment of CUD with a minimum follow-up of 4 weeks in any in/outpatient setting, with no restriction on geographic location. Participants included adults with diagnosed CUD. Participants with co-occurring substance use disorders and/or common mental health conditions were eligible. We assessed risk of bias using the Cochrane Risk of Bias 2 tool and certainty of evidence was assessed using the Confidence in Network Meta-analysis framework. We assessed 12 effectiveness, three acceptability and two safety outcomes. Our primary outcomes were continuous abstinence, point abstinence, dropout for any reason and serious adverse events. We also examined longest duration of continuous abstinence, extent of cocaine use, craving, severity of dependence, dropout due to adverse events, adherence and mortality.

resultsWe included 218 reports of 163 studies (14 871 participants) assessing 89 unique medications, grouped into 8 categories (agonist/replacement approaches; antidepressants and other serotonergic agents; glutamate modulators; anticonvulsants and GABAergic agents; antagonist/blocker approaches; opioid agonists and antagonists; combination pharmacotherapy; other neuroactive agents). Most study results had some concerns or high risk of bias, and the results of syntheses were generally judged to be very low certainty evidence. As such, the findings ought to be interpreted with caution. No single treatment type showed consistent beneficial effects across all effectiveness outcomes and there was limited evidence that results varied by intervention type or presence of co-occurring comorbidity.

conclusionsIn a comprehensive network meta-analysis, we found no convincing evidence for the effectiveness of any pharmacological treatments for cocaine use disorder.

Indexed as

Cocaine-Related DisordersHumansRandomized Controlled Trials as TopicTreatment Outcomecocaine use disordernetwork meta‐analysispharmacotherapysafety and acceptabilitysystematic reviewtreatment effectiveness

Identifiers

PMID42483790
PMCPMC13677807

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.