Effect of antidepressants for cessation therapy in betel-quid use disorder: a randomised, double-blind, placebo-controlled trial. (2020)

• Record Type: Journal Article
• Authors: Hung, Chung-Chieh; Lee, Chien-Hung; Ko, Albert Min-Shan; Lane, Hsien-Yuan; Lee, Chi-Pin; Ko, Ying-Chin
• Is Part Of: Epidemiology and psychiatric sciences. Volume 29(2020)
• Publication Date: 2020
• Subjects: Clinical drug studies, -- common mental disorders, -- epidemiology, -- psychoactive substance use disorder, -- randomised controlled trials; Epidemiology -- Periodicals; Mental illness -- Periodicals; Community psychiatry -- Periodicals; 362.2
• DOI: 10.1017/S2045796020000384
• Languages: English
• ISSNs: 2045-7960

Abstract

Abstract: Aims: More than one-half of betel-quid (BQ) chewers have betel-quid use disorder (BUD). However, no medication has been approved. We performed a randomised clinical trial to test the efficacy of taking escitalopram and moclobemide antidepressants on betel-quid chewing cessation (BQ-CC) treatment. Methods: We enrolled 111 eligible male BUD patients. They were double-blinded, placebo-controlled and randomised into three treatment groups: escitalopram 10 mg/tab daily, moclobemide 150 mg/tab daily and placebo. Patients were followed-up every 2 weeks and the length of the trial was 8 weeks. The primary outcome was BQ-CC, defined as BUD patients who continuously stopped BQ use for ⩾6 weeks. The secondary outcomes were the frequency and amount of BQ intake, and two psychological rating scales. Several clinical adverse effects were measured during the 8-week treatment. Results: Intention-to-treat analysis shows that after 8 weeks, two (5.4%), 13 (34.2%) and 12 (33.3%) of BUD patients continuously quit BQ chewing for ⩾6 weeks among placebo, escitalopram, moclobemide groups, respectively. The adjusted proportion ratio of BQ-CC was 6.3 (95% CI 1.5–26.1) and 6.8 (95% CI 1.6–28.0) for BUD patients who used escitalopram and moclobemide, respectively, as compared with those who used placebo. BUD patients with escitalopram and moclobemide treatments both exhibited a significantly lower frequency and amount of BQ intake at the 8th week than those with placebo. Conclusions: Prescribing a fixed dose of moclobemide and escitalopram to BUD patients over 8 weeks demonstrated treatment benefits to BQ-CC. Given a relatively small sample, this study provides preliminary evidence and requires replication in larger trials.