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Urine toxicology for cocaine was determined by semi-quantitative analysis of benzoylecognine (BE) concentration with results available in 24?hours. During the first week, vouchers can be earned either if the BE concentration is reduced by at least 50% compared to the previous sample, suggesting no use since the last visit, or if the BE concentration fell below 300?ng/ml.[19] For a positive urine [http://www.selleckchem.com/products/Neratinib(HKI-272).html Neratinib in vivo] sample, the voucher is not earned, but the patient can reinstate the previous voucher level by producing a negative urine at the next visit. Hence, voucher earnings are a sensitive measure of the cumulation of abstinence days. Hamilton Depression Scale (Ham-D 25[20]) and craving scale (Likert scale from 0 to 10, 10?=?highest frequency per 24?hours) scores were computed 3��/week during the lead-in. Ham-D 25 item # 9, 10, 11, early, middle, late insomnia were separately computed to evaluate sleep disturbance. At the end of the lead-in, voucher gains and number of cocaine craving days are totaled for each patient. Full completion of the lead-in determined ��retained�� status. A 50% drop in Ham-D 25, from a study-entry score that had to exceed 12, determined a mood responder status. Three negative cocaine urines during the second week defined abstinent status. At the beginning of the lead-in, patients were given two kits of salivettes? with a diary for the salivary cortisol collection. Collections were done at home on two consecutive days.[14] Patients were instructed on how to collect the samples between 8 and 9?AM before [http://en.wikipedia.org/wiki/RVX_208 RVX-208] eating, at 1�C2?PM, at 5�C6?PM, then refrigerate them until returned. At bedtime before the second collection day, patients took .1?mg of dexamethasone to test for suppression of cortisol secretion (DST). Suppression was noted when the AM cortisol levels was 50% lower than pre-suppression level. In the diaries, [http://www.selleckchem.com/products/BMS-777607.html BMS-777607 order] patients recorded what they consumed and at what time, and any stressor. Cortisol concentration was measured by ELISA methodology at the Nathan Kline Analytic Psychopharmacology Laboratory in Orangeburg, NY. Intra-assay and inter-assay coefficients of variation were 2.9% and 5%, respectively. Seventy-seven participants completed saliva collection at baseline, 65 samples (85%) were analyzed for secretion profile and total secretion; and 64 (83%) for dexamethasone suppression. Sixty-five diurnal cortisol secretion profiles were coded categorically (typical vs. atypical) according to clinically accepted criteria[21, 22] by two independent raters. In a typical pattern, cortisol levels peak in the early morning hours (usually 6�C9?AM), then decline sharply from the midday hours until it increases again in the pre-waking hours (n?=?34). Deviations from this profile, in which cortisol levels remain unchanged or increased through the daytime hours, were termed atypical (n?=?31). Inter-rater reliability (��) was .94 (Fig. 1).