Abstract
Cocaine addiction continues to be an important public health problem worldwide. At present, there are no proven pharmacotherapies for cocaine addiction. The studies reviewed here revealed a number of emerging targets for cocaine pharmacotherapy. First, disulfiram, a medication with dopaminergic effects, reduced cocaine use in a number of clinical trials. Second, GABA medications, tiagabine and topiramate, were found promising in clinical trials. Third, a beta-adrenergic blocker, propranolol, may be effective especially among cocaine-addicted individuals with high withdrawal severity. Fourth, treatment with a stimulant medication, modafinil, has reduced cocaine use. Last, a cocaine vaccine that slows entry of cocaine into the brain holds promise. These promising findings need to be further tested in controlled clinical trials.
MeSH terms
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Adrenergic beta-Antagonists / therapeutic use
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Animals
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Benzhydryl Compounds / therapeutic use
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Brain / drug effects*
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Brain / enzymology
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Central Nervous System Stimulants / therapeutic use
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Cocaine / immunology
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Cocaine-Related Disorders / drug therapy*
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Disulfiram / pharmacology
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Disulfiram / therapeutic use
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Dopamine / metabolism
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Dopamine Agents / pharmacology
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Dopamine Agents / therapeutic use
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Dopamine beta-Hydroxylase / antagonists & inhibitors
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Dopamine beta-Hydroxylase / metabolism
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Drug Evaluation, Preclinical
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Enzyme Inhibitors / therapeutic use
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GABA Agonists / therapeutic use
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GABA Plasma Membrane Transport Proteins / metabolism
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GABA Uptake Inhibitors
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Humans
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Modafinil
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Nipecotic Acids / therapeutic use
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Propranolol / therapeutic use
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Randomized Controlled Trials as Topic
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Tiagabine
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Vaccines / therapeutic use
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gamma-Aminobutyric Acid / metabolism
Substances
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Adrenergic beta-Antagonists
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Benzhydryl Compounds
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Central Nervous System Stimulants
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Dopamine Agents
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Enzyme Inhibitors
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GABA Agonists
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GABA Plasma Membrane Transport Proteins
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GABA Uptake Inhibitors
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Nipecotic Acids
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SLC6A1 protein, human
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Vaccines
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gamma-Aminobutyric Acid
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Propranolol
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Dopamine beta-Hydroxylase
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Cocaine
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Modafinil
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Disulfiram
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Dopamine
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Tiagabine