title: Pharmacological treatments for cocaine dependence: is there something new?
abstract: BACKGROUND
  There is no specific and approved treatment, by regulatory authorities, for cocaine dependence. Therefore, developing new medications for the treatment of this disease continues to be a research priority. Recent advances in neurobiology and brain imaging studies have suggested several promising pharmacological approaches.
  
  
  METHODS
  Literature searches were conducted for the period from January 1990 to February 2011 using PubMed, EMBASE, PsycInfo, the NIDA research monograph index and the reference list of clinicaltrials.gov, which are the main electronic sources of ongoing trials.
  
  
  RESULTS
  Recent controlled clinical studies have highlighted some very promising medications, especially glutamatergic (N-Acetylcysteine, modafinil, topiramate) and GABAergic (vigabatrin) agents, agonist replacement therapy (sustained-release methylphenidate, d-amphetamine) and dopamine agents (disulfiram). Additionally, immunotherapy is a new and promising pharmacological approach.
  
  
  CONCLUSIONS
  Promising pharmacological approaches have emerged for the treatment of cocaine dependence, but larger, randomized, placebo-controlled studies are needed for some medications. Preclinical studies suggest new targets of interest in cocaine dependence. The optimal therapeutic platform is the combination of pharmacotherapies with behavioral therapies.
authors.affiliation: Addiction Research and Treatment Center, Paul-Brousse Hospital (Assistance Publique-Hôpitaux de Paris [AP-HP]), Villejuif, France. laurent.karila@gmail.com
authors.forename: Laurent
authors.initials: L
authors.lastname: Karila
authors.forename: Michel
authors.initials: M
authors.lastname: Reynaud
authors.forename: Henri-Jean
authors.initials: HJ
authors.lastname: Aubin
authors.forename: Benjamin
authors.initials: B
authors.lastname: Rolland
authors.forename: Dewi
authors.initials: D
authors.lastname: Guardia
authors.forename: Olivier
authors.initials: O
authors.lastname: Cottencin
authors.forename: Amine
authors.initials: A
authors.lastname: Benyamina
mesh_terms: D000818:Animals; D001921:Brain / Q000378:metabolism; D019970:Cocaine-Related Disorders / Q000188:drug therapy* / Q000453:epidemiology; D018849:Controlled Clinical Trials as Topic; D003952:Diagnostic Imaging / Q000379:methods; D016503:Drug Delivery Systems; D015195:Drug Design; D004353:Drug Evaluation, Preclinical; D006801:Humans; D009446:Neurobiology / Q000379:methods