title: Emerging pharmacological strategies in the fight against cocaine addiction.
abstract: 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.
authors.affiliation: Department of Psychiatry, VA Connecticut Healthcare System, Yale University, School of Medicine, West Haven, CT 06516, USA. Mehmet.Sofuoglu@yale.edu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Sofuoglu
authors.forename: Thomas R
authors.initials: TR
authors.lastname: Kosten
mesh_terms: 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
chemical_list: 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