Several studies have demonstrated that ACh modulates the dopaminergic circuit in the nucleus accumbens, and its blockade appears to be associated with the inhibition of the reinforced effect or the increase in dopamine caused by cocaine use. The objective of this study was to evaluate the effect of biperiden (a muscarinic receptor antagonist with a relatively higher affinity for the M1 receptor) on crack/cocaine use relapse compared to a control group that received placebo. This study is a double-blind, randomized, placebo-controlled clinical trial. The intervention group received 2 mg of biperiden, 3 times a day, for a period of 3 months. The control group received identical placebo capsules, at the same frequency and over the same period. All participants were followed for a period of six months. The sample comprised 128 people, with 61 in the control group and 67 in the biperiden group. Lower substance consumption was observed in the group that received biperiden treatment two (bT2 = −2.2 [−3.3; −1.0], p < 0.001) and six months (bT4 = −6, 2 [−8.6; −3.9], p < 0.001) after the beginning of the intervention. The biperiden group had a higher latency until a possible first day of consumption, in the same evaluation periods (bT2 = 0.26 [0.080; 0.44], p = 0.004; bT4 = 0.63 [0.32; 0.93], p < 0.001). Despite the major limitations of the present study, the group that received biperiden reduced the number of days of cocaine/crack use and showed an increase in the latency time for relapse. More studies are needed to confirm the utility of this approach.

中文翻译：

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服用比哌立登以减少可卡因/快克吸毒者复发的初步研究：一项随机对照临床试验

多项研究表明，ACh 调节伏隔核中的多巴胺能回路，其阻断似乎与抑制可卡因使用引起的强化效应或多巴胺增加有关。本研究的目的是评估与接受安慰剂的对照组相比，比哌立登（一种对 M1 受体具有相对较高亲和力的毒蕈碱受体拮抗剂）对快克/可卡因吸毒复发的影响。本研究是一项双盲、随机、安慰剂对照临床试验。干预组接受比哌立登2mg，每天3次，为期3个月。对照组以相同的频率和相同的时间段接受相同的安慰剂胶囊。所有参与者都接受了为期六个月的随访。样本包括 128 人，其中对照组 61 人，比哌立登组 67 人。在接受比哌立登治疗 2 个月 (bT2 = -2.2 [-3.3; -1.0], p < 0.001) 和六个月 (bT4 = -6, 2 [-8.6; -3.9], p < 0.001) 的组中观察到较低的物质消耗0.001）干预开始后。在相同的评估期内，比哌立登组在可能的第一天服用之前的潜伏期较长（bT2 = 0.26 [0.080; 0.44]，p = 0.004；bT4 = 0.63 [0.32; 0.93]，p < 0.001）。尽管本研究存在重大局限性，但接受比哌立登治疗的组减少了可卡因/快克使用的天数，并显示出复发潜伏期的增加。需要更多的研究来证实这种方法的实用性。