Importance No medication has been established as an efficacious treatment for cocaine dependence. We hypothesized that dual modulation of the mesocorticolimbic dopamine system by topiramate—a glutamate receptor antagonist and ?-aminobutyric acid receptor agonist—would result in efficacious treatment for cocaine dependence compared with placebo. Objective To determine the efficacy of topiramate vs placebo as a treatment for cocaine dependence.

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Abstract: Objectives: The aim of this research was to investigate whether a training intervention to enhance collaboration between mental health and primary care professionals improved the detection and management of mental health problems in primary health care in four large cities in Brazil. The training intervention was a multifaceted program over 96 h focused on development of a shared care model.Method: A quasiexperimental study design was undertaken with assessment of performance by nurse and general practitioners (GPs) pre- and postintervention. Rates of recognition of mental health disorders (compared with the General Health Questionnaire) were the primary outcome, while self-reports of patient-centered care, psychosocial interventions and referral were the secondary outcomes.Results: Six to 8 months postintervention, no changes were observed in terms of rate of recognition across the entire sample.

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