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Pharmacotherapies for cocaine dependence.

G O'Leary1, R D Weiss

  • 1Harvard Medical School, Alcohol and Drug Abuse Treatment Program, McLean Hospital, 115 Mill Street, Belmont, MA 02478, USA. olearyg4@aol.com

Current Psychiatry Reports
|December 21, 2000
PubMed
Summary

This review explores past and current pharmacologic treatments for cocaine dependence. Novel therapies like disulfiram and a cocaine vaccine show promise for effective addiction management.

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Area of Science:

  • Pharmacology
  • Addiction Medicine
  • Neuroscience

Background:

  • Cocaine dependence is a significant public health issue with limited effective treatments.
  • Pharmacologic interventions have been investigated for decades with mixed results.
  • Understanding the neurobiological underpinnings of cocaine addiction is crucial for developing targeted therapies.

Purpose of the Study:

  • To review the historical development of pharmacologic trials for cocaine dependence.
  • To discuss the rationale and outcomes of various drug classes investigated.
  • To highlight emerging and innovative pharmacologic treatments currently under investigation.

Main Methods:

  • Literature review of historical and recent clinical trials.
  • Analysis of pharmacologic agents targeting dopaminergic pathways, mood regulation, and aversive conditioning.
  • Presentation of data from studies on disulfiram, dopamine antagonists, citicoline, aspirin, and vaccines.

Main Results:

  • Early clinical trials yielded inconsistent results, attributed to methodological variations and patient factors.
  • Agents like dopaminergic agents, antidepressants, and anticonvulsants have shown potential but require further validation.
  • Recent studies indicate promising outcomes for novel agents including disulfiram and a cocaine-specific vaccine.

Conclusions:

  • Pharmacologic treatment for cocaine dependence remains challenging, necessitating continued research.
  • Innovative approaches, including vaccines and targeted neurobiological agents, offer new hope.
  • A multi-faceted treatment strategy combining pharmacotherapy with behavioral interventions is likely optimal.

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