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Roger D. Weiss, MD
Harvard Medical School McLean Hospital Belmont, Mass

JAMA. 1989;261(22):3239.

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In Reply. —

I appreciate and concur with the comment by Dr Clark regarding the need to employ a primary disease model in the treatment of chemically dependent patients. However, I must disagree with some of his other statements. For example, he says that "desipramine in the treatment of cocaine addiction is useful only for a short time after cocaine withdrawal." There is no evidence in the research literature that either supports or refutes this categorical statement, since the use of desipramine in cocaine abusers for anything except initiation of abstinence has never been studied systematically. Because desipramine is currently in widespread use in substance abuse treatment centers around the country, it seems critical to identify both the utility and the limits of this drug in the treatment of cocaine-dependent patients. This is the first report, to my knowledge, that identifies specific circumstances in which the use of desipramine might . . . [Full Text PDF of this Article]

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