title: Cognitive enhancers in the treatment of substance use disorders: clinical evidence.
abstract: Attenuation of drug reward has been the major focus of medication development in the addiction area to date. With the growth of research in the area of cognitive neuroscience, the importance of executive function and inhibitory cognitive control in addictive disorders is becoming increasingly apparent. An emerging strategy in the pharmacotherapy of addictions and other psychiatric disorders involves the use of medications that improve cognitive function. In particular, agents that facilitate inhibitory and attentional control, improve abstraction, planning and mental flexibility could be beneficial in the treatment of substance use disorders. Because there are multiple neurotransmitter systems involved in the regulation of cognitive function, agents from a number of drug classes have been tested. In particular, agents acting through the cholinergic, adrenergic and glutamatergic systems have shown potential for improving cognitive function in a number of psychiatric and neurologic disorders, but most of these agents have not been tested in the treatment of individuals with substance use disorders. This manuscript provides a review of clinical data supporting the use of the major classes of cognitive enhancing agents in substance use disorders. Agents that have shown promise in cognitive enhancement in other disorders, and have a theoretical or mechanistic rationale for application to substance use disorders are also highlighted.
authors.affiliation: Medical University of South Carolina, Department of Psychiatry, 67 President Street, Charleston, SC 29425, USA. bradyk@musc.edu
authors.forename: Kathleen T
authors.initials: KT
authors.lastname: Brady
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Gray
authors.forename: Bryan K
authors.initials: BK
authors.lastname: Tolliver
mesh_terms: D018663:Adrenergic Agents / Q000627:therapeutic use; D001559:Benzhydryl Compounds / Q000627:therapeutic use; D000697:Central Nervous System Stimulants / Q000627:therapeutic use; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D003071:Cognition / Q000187:drug effects / Q000502:physiology; D018683:Excitatory Amino Acid Agents / Q000627:therapeutic use; D006801:Humans; D000077408:Modafinil; D018377:Neurotransmitter Agents / Q000627:therapeutic use; D018722:Nicotinic Agonists / Q000627:therapeutic use; D018697:Nootropic Agents / Q000627:therapeutic use*; D019966:Substance-Related Disorders / Q000188:drug therapy* / Q000503:physiopathology / Q000523:psychology
chemical_list: D018663:Adrenergic Agents; D001559:Benzhydryl Compounds; D000697:Central Nervous System Stimulants; D002800:Cholinesterase Inhibitors; D018683:Excitatory Amino Acid Agents; D018377:Neurotransmitter Agents; D018722:Nicotinic Agonists; D018697:Nootropic Agents; D000077408:Modafinil