Subjective and electroencephalographic reactions to cocaine cues were evaluated in 33 cocaine-dependent out-patients and 17 non-cocaine-dependent controls. Subjective, EEG, and autonomic reactions to three 5-min videos (cocaine-associated, erotic, neutral) were evaluated twice with an interpolated 1-week interval. Between evaluations, cocaine-dependent patients received carbamazepine 400 mg daily or matching placebo in double-blind fashion. In all three groups the cocaine-associated and erotic videos produced a comparable increase in the self-rated desire for cocaine and reduction in total EG power. Carbamazepine treatment increased EEG fast alpha power and self-rated fatigue, and decreased self-rated concentration and vigor. However, it had no specific effect on subjective or physiological reactivity to either the cocaine-associated or erotic videos. This negative finding is consistent with recent clinical trials of carbamazepine for cocaine dependence.