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Open Access Highly Accessed Review

Novel pharmacotherapeutic treatments for cocaine addiction

Daryl Shorter12* and Thomas R Kosten12

Author affiliations

1 Menninger Department of Psychiatry and Behavioral Science, Baylor College of Medicine, 1977 Butler Blvd., Suite E4.400, Houston, TX 77030, USA

2 MEDVAMC - 2002 Holcombe Blvd., Bldg 110, Room 229, Houston, TX 77030, USA

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Citation and License

BMC Medicine 2011, 9:119  doi:10.1186/1741-7015-9-119

Published: 3 November 2011

Abstract

Cocaine is a stimulant that leads to the rapid accumulation of catecholamines and serotonin in the brain due to prevention of their re-uptake into the neuron that released the neurotransmitter. Cocaine dependence is a public health concern and cause of significant morbidity and mortality worldwide. At present, there are no approved medications for the treatment of this devastating illness, and behavioral interventions have proven to be of limited use. However, there have been a number of recent trials testing promising agents including dopamine agonists, GABAergic medications and the cocaine vaccine. Here we discuss the most recent human clinical trials of potential medications for treatment of cocaine dependence, as well as pre-clinical studies for another promising agent, levo tetrahydropalmatine. Examination of these recent findings shows promise for GABAergic medications and the cocaine vaccine, as well as unique medications such as disulfiram, whose mechanism remains to be determined. Future work may also confirm specific subgroups of patients for treatment response based on clinical characteristics, biomarkers and pharmacogenetics. This review highlights the need for further, bigger studies in order to determine optimal clinical usage.