Emerging pharmacological strategies in the fight against cocaine addiction.
Cocaine addiction continues to be an important public health problem worldwide. At present, there are no proven pharmacotherapies for cocaine addiction. The studies reviewed here revealed a number of emerging targets for cocaine pharmacotherapy. First, disulfiram, a medication with dopaminergic effects, reduced cocaine use in a number of clinical trials. Second, GABA medications, tiagabine and topiramate, were found promising in clinical trials. Third, a beta-adrenergic blocker, propranolol, may be effective especially among cocaine-addicted individuals with high withdrawal severity. Fourth, treatment with a stimulant medication, modafinil, has reduced cocaine use. Last, a cocaine vaccine that slows entry of cocaine into the brain holds promise. These promising findings need to be further tested in controlled clinical trials.
Sofuoglu
Mehmet
M
Department of Psychiatry, VA Connecticut Healthcare System, Yale University, School of Medicine, West Haven, CT 06516, USA. Mehmet.Sofuoglu@yale.edu
Kosten
Thomas R
TR
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000818:Animals; D001559:Benzhydryl Compounds / Q000627:therapeutic use; D001921:Brain / Q000187:drug effects* / Q000201:enzymology; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D003042:Cocaine / Q000276:immunology; D019970:Cocaine-Related Disorders / Q000188:drug therapy*; D004221:Disulfiram / Q000494:pharmacology / Q000627:therapeutic use; D004298:Dopamine / Q000378:metabolism; D015259:Dopamine Agents / Q000494:pharmacology / Q000627:therapeutic use; D004299:Dopamine beta-Hydroxylase / Q000037:antagonists & inhibitors / Q000378:metabolism; D004353:Drug Evaluation, Preclinical; D004791:Enzyme Inhibitors / Q000627:therapeutic use; D018755:GABA Agonists / Q000627:therapeutic use; D050485:GABA Plasma Membrane Transport Proteins / Q000378:metabolism; D058805:GABA Uptake Inhibitors; D006801:Humans; D000077408:Modafinil; D009557:Nipecotic Acids / Q000627:therapeutic use; D011433:Propranolol / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D000078308:Tiagabine; D014612:Vaccines / Q000627:therapeutic use; D005680:gamma-Aminobutyric Acid / Q000378:metabolism
D000319:Adrenergic beta-Antagonists; D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D015259:Dopamine Agents; D004791:Enzyme Inhibitors; D018755:GABA Agonists; D050485:GABA Plasma Membrane Transport Proteins; D058805:GABA Uptake Inhibitors; D009557:Nipecotic Acids; C493413:SLC6A1 protein, human; D014612:Vaccines; D005680:gamma-Aminobutyric Acid; D011433:Propranolol; D004299:Dopamine beta-Hydroxylase; D003042:Cocaine; D000077408:Modafinil; D004221:Disulfiram; D004298:Dopamine; D000078308:Tiagabine