Importance: Cocaine dependence is a significant public health problem, yet no validated pharmacological treatment exists. The potent ␥-aminobutyric acid (GABA) ergic medication vigabatrin has previously been shown to be effective in a double-blind single-site study conducted in Mexico.Objective: To evaluate the safety and efficacy of vigabatrin for the treatment of cocaine dependence in a US sample.Design and Setting: Multisite, randomized, doubleblind, placebo-controlled, 12-week clinical trial with follow-up visits at weeks 13, 16, 20, and 24 in 11 US sites.Participants: In total, 186 treatment-seeking participants with cocaine dependence (mean age, 45 years). Approximately 67% were male, and about 60% were of African American race/ethnicity.Interventions: Participants received twice-daily doses of vigabatrin (total dosage, 3.0 g/d) or matched placebo, plus weekly computerized cognitive behavioral therapy and biweekly individual counseling for 13 weeks. Contingency management encouraged the provision of urine samples.Main Outcomes and Measures: The primary outcome measure was the proportion of participants with cocaine abstinence during the last 2 weeks of the 12week treatment phase as assessed by self-reports and quan-