Novel pharmacotherapeutic treatments for cocaine addiction

BMC Med. 2011 Nov 3;9:119. doi: 10.1186/1741-7015-9-119.

Abstract

Cocaine is a stimulant that leads to the rapid accumulation of catecholamines and serotonin in the brain due to prevention of their re-uptake into the neuron that released the neurotransmitter. Cocaine dependence is a public health concern and cause of significant morbidity and mortality worldwide. At present, there are no approved medications for the treatment of this devastating illness, and behavioral interventions have proven to be of limited use. However, there have been a number of recent trials testing promising agents including dopamine agonists, GABAergic medications and the cocaine vaccine. Here we discuss the most recent human clinical trials of potential medications for treatment of cocaine dependence, as well as pre-clinical studies for another promising agent, levo tetrahydropalmatine. Examination of these recent findings shows promise for GABAergic medications and the cocaine vaccine, as well as unique medications such as disulfiram, whose mechanism remains to be determined. Future work may also confirm specific subgroups of patients for treatment response based on clinical characteristics, biomarkers and pharmacogenetics. This review highlights the need for further, bigger studies in order to determine optimal clinical usage.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Review

MeSH terms

  • Berberine Alkaloids / therapeutic use
  • Clinical Trials as Topic
  • Cocaine-Related Disorders / drug therapy*
  • Disulfiram / therapeutic use
  • Dopamine Agonists / therapeutic use
  • GABA Agents / therapeutic use
  • Humans
  • Treatment Outcome
  • Vaccination / methods

Substances

  • Berberine Alkaloids
  • Dopamine Agonists
  • GABA Agents
  • tetrahydropalmatine
  • Disulfiram