Advertisement

Cocaine pp 149-165 | Cite as

Pharmacological Treatments

  • Mark S. Gold
Part of the Drugs of Abuse book series (DOAC, volume 3)

Abstract

At this time, the pharmacological treatments for cocaine addiction are adjunctive and are not intended as exclusive stand-alone treatments. Rather, their primary utility stems from helping patients to remain abstinent and involved in other therapies while coping with the craving and withdrawal associated with cocaine. Pharmacological treatments may be used for any bona fide preexisting or concurrent psychiatric conditions. As a result, these pharmacological treatments can be valuable tools in helping a patient to benefit from the behavioral, rehabilitative, psychotherapeutic, family, and group therapy (including self-help) treatment regimen used to promote a successful recovery. Nevertheless, our increasing knowledge of the physiological effects of cocaine has led to numerous attempts to improve and widen the scope of the pharmacotherapy. Table 7.1 lists the most common pharmacological treatments for cocaine dependence.

Keywords

Cocaine Abuse Cocaine Dependence Chronic Cocaine Cocaine Addiction Acute Cocaine 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Weiss RD, Mirin SM. Psychological and pharmacological treatment strategies in cocaine dependence. Ann Clin Psychiatry. 1990;2:239–243.CrossRefGoogle Scholar
  2. 2.
    Vaughan RA, Simantov R, Lew R, Kuhar MJ. A rapid binding assay for solubilized dopamine transporters using [3H]WIN 35,428. J Neurosci Methods. 1991;40:9–16.PubMedCrossRefGoogle Scholar
  3. 3.
    Goldfrank LR, Hoffman RS. American Association of Poison Control Centers National Data Collection System. Ann Emerg Med. 1991;20:165–170.PubMedCrossRefGoogle Scholar
  4. 4.
    Post RM, Weiss SRB, Aigner TC. Carbamazepine in the treatment of cocaine abuse. Paper presented at the Conference on the Biological Basis of Addiction; Santa Monica, Calif; January 11, 1991.Google Scholar
  5. 5.
    Golwyn DH. Cocaine abuse treated with phenelzine. Int J Addict. 1988;23:897–905.PubMedGoogle Scholar
  6. 6.
    Gawin FH, Kleber HD, Byck R, et al. Desipramine facilitation of initial cocaine abstinence. Arch Gen Psychiatry. 1989;46:117–121.PubMedCrossRefGoogle Scholar
  7. 7.
    Weiss RD, Pope HG Jr, Mirin SM. Treatment of chronic abuse and attention deficit disorder, residual type, with magnesium pemoline. Drug Alcohol Depend. 1985;15:69–72.PubMedCrossRefGoogle Scholar
  8. 8.
    Khantzian EJ. An extreme case of cocaine dependence and marked improvement with methylphenidate treatment. Am J Psychiatry. 1983;140:784–785.PubMedGoogle Scholar
  9. 9.
    Wise RA. The neurobiology of craving: implications for the understanding and treatment of addiction. J Abnormal Psychol 1988;97(2)118–132.CrossRefGoogle Scholar
  10. 10.
    Gold MS, Pottash ALC, Extein I, et al. Clonidine in acute opiate withdrawal. N Eng J Med. 1980;302:1421.Google Scholar
  11. 11.
    Dackis CA, Gold MS. Pharmacological approaches to cocaine addiction. J Substance Abuse Treatment. 1985;2:139.CrossRefGoogle Scholar
  12. 12.
    Dackis CA, Gold MS. Treatment strategies for cocaine detoxification. Lakowski JM, Galloway MP, White FP, eds. In Cocaine: Pharmacology, Physiology, and Clinical Strategies. Boca Raton, Fla: CRC Press; 1992: Chap 19.Google Scholar
  13. 13.
    Extein IL, Gross DA, Gold MS. Cocaine detoxification using bromocriptine. Am Psychiatric Assoc; 1986. Abstract NR 70.Google Scholar
  14. 14.
    Giannini AJ, Baumgartel P, Dimarzio LR. Bromocriptine therapy in cocaine withdrawal. J Clin Pharmacol. 1987;27:267.PubMedGoogle Scholar
  15. 15.
    Malcolm R. Pergolide, bromocriptine trial in cocaine addiction. Am Psychiatric Assoc; 1992. Abstract NR:332.Google Scholar
  16. 16.
    Tennant FS, Sagherian AA. Double-blind comparison of amantadine hydrochloride and bromocriptine mesylate for ambulatory withdrawal from cocaine dependence. Arch Intern Med. 1987;147:109.PubMedCrossRefGoogle Scholar
  17. 17.
    Gold MS, Dackis CA. New insights and treatments: opiate withdrawal and cocaine addiction. Clin Ther. 1984;7:6–21.PubMedGoogle Scholar
  18. 18.
    Dackis CA, Gold MS. New concepts in cocaine addiction: the dopamine depletion hypothesis. Neurosci Biobehav Rev. 1985;9: 469–477.PubMedCrossRefGoogle Scholar
  19. 19.
    Spyraki C, Fibinger HC. Behavioral evidence for supersensitivity of postsynaptic dopamine receptors in the mesolimbic system after chronic administration of desipramine. Eur J Pharmacol. 1981;74:195.PubMedCrossRefGoogle Scholar
  20. 20.
    Gawin FH. Cocaine addiction: psychology and neurophysiology. Science. 1991;251:1580–1585.PubMedCrossRefGoogle Scholar
  21. 21.
    Weiss RD, Mirin SM, and Michael JL. Relapse to cocaine abuse after initiating desipramine treatment. JAMA. 1988;260:2545.PubMedCrossRefGoogle Scholar
  22. 22.
    Kosten TR, Morgan CM, Falcione J, Schotenfeld RS. Pharmacotherapy for cocaine abusing methadone maintained patients using amantadine or desipramine. Arch Gen Psychiatry 49:904–908, 1992.CrossRefGoogle Scholar
  23. 23.
    Arndt IO, Dorozynsky L, Woody GE, McLellan AT, O’Brien CP. Desipramine treatment of cocaine dependence in methadone maintenance patients. Arch Gen Psychiatry 49:904–908, 1992.CrossRefGoogle Scholar
  24. 24.
    Pharmacological Effects of Antidepressants, Version II Physicians Postgraduate Press, Inc; 1992.Google Scholar
  25. 25.
    Meyer RE. New pharmacotherapies for cocaine dependence … revisited. Arch Gen Psychiatry 49:900–904, 1992.PubMedCrossRefGoogle Scholar
  26. 26.
    Kosten TR. Behavioral and pharmacologic treatments for cocaine dependence. Treatment challenges in the 1990s. Washington, DC: American Psychiatric Association; May 1992.Google Scholar
  27. 27.
    Post RM. Time course of clinical effects of carbamazepine: implication for mechanism of action. J Clin Psychiatry. 1988;49(suppl) 4(1):35–46.Google Scholar
  28. 28.
    Halikas JA, Kuhn KL, Crea FS, et al. Treatment of crack cocaine use with carbamazepine. Am J Drug Alcohol Abuse. 1992;18(1): 45–56.PubMedCrossRefGoogle Scholar
  29. 29.
    Gastfriend DR, Mendelson JH, Mello NK, Teoh SK. Preliminary results of an open trial of buprenorphine in the outpatient treatment of combined heroin and cocaine dependence. Committee on Problems of Drug Dependence, 53rd Annual Scientific Meeting; Palm Beach, Fla; June 16–20, 1991.Google Scholar
  30. 30.
    Grayson NA, Witkin JM, Katz JL, Cowan A, Rice KC. Actions of buprenorphine of cocaine and opiate mediated effects. Committee on Problems of Drug Dependence, 53rd Annual Scientific Meeting; Palm Beach, Fla; June 16-20, 1991.Google Scholar
  31. 31.
    Kosten TR, Schottenfeld RS, Morgan C, Falcioni J, Ziedonis D. Buprenorphine vs. methadone for opioid and cocaine dependence. Committee on Problems of Drug Dependence, 53rd Annual Scientific Meeting; Palm Beach, Fla; June 16-20, 1991.Google Scholar
  32. 32.
    Cone E, Holicky B, Pickworth W, Johnson RE. Pharmacologic and behavioral effects of high doses of intravenous buprenorphine. Committee on Problems of Drug Dependence, 53rd Annual Scientific Meeting; Palm Beach, Fla; June 16-20, 1991.Google Scholar
  33. 33.
    Kosten TR. Behavioral and pharmacologic treatments for cocaine dependence. American Psychiatric Association Symposium: Treatment Challenges in the 1990s. May 1992. Washington, D.C.Google Scholar
  34. 34.
    Washton AM, Pottash ALC, Gold MS. Naltrexone in addicted business executives and physicians. J Clin Psychiatry. 1984;45(9): 39–41.PubMedGoogle Scholar
  35. 35.
    Ramsey NF, van Ree JM. Intracerebroventricular naltrexone treatment attenuates acquisition of intravenous cocaine self-administration in rats. Pharm Biochem Behav. 1991;40:807–810.CrossRefGoogle Scholar
  36. 36.
    Volpicelli JR, Berg BJ, Alterman AI, et al. Naltrexone in the treatment of alcohol dependence. New Research #331, American Psychiatric Association Annual Meeting, Washington DC, May 1992.Google Scholar
  37. 37.
    Filibeck U, Cabib S, Castellana C, Puglisi-Allegra S. Chronic cocaine enhances defensive behaviors in the laboratory mouse: involvement of the D2 dopamine receptors. Psychopharmacology. 1988;96:437–441.PubMedCrossRefGoogle Scholar
  38. 38.
    Goeders NE, Smith JE. Cortical dopaminergic involvement in cocaine reinforcement. Science. 1983; 221(4612):773–775.PubMedCrossRefGoogle Scholar
  39. 39.
    Daekis CA, Gold MS, Davies RK, Sweeney DR. Bromocriptine treatment for cocaine abuse: the dopamine depletion hypothesis. Int J Psychiatry Med. 1985;15:125.CrossRefGoogle Scholar
  40. 40.
    Meert TF, Janssen PA. Ritanserin, a new therapeutic approach for drug abuse. Part 2: effects on cocaine. Drug Develop Res. 1992;25:39–53.CrossRefGoogle Scholar

Copyright information

© Plenum Publishing Corporation 1993

Authors and Affiliations

  • Mark S. Gold
    • 1
  1. 1.Departments of Neuroscience and PsychiatryUniversity of Florida College of MedicineGainesvilleUSA

Personalised recommendations