Treatment of cocaine abuse

 

There is currently no pharmacological treatment with a proven efficacy for cocaine dependence, despite research in the manipulation of DA transmission with the use of DA agonists such as amantadine.

 

A Cochrane review found there was no statistical difference in the relapse rate with a dopamine agonist vs a placebo, therefore it does not advocate the use of dopamine agonists in cocaine dependence.

 

Research was also carried out in to the use of disulfiram due to the possible inhibition of dopamine-beta-hydroxylase, resulting in an excess of dopamine and decreased synthesis of noradrenaline. It was found that although there were fewer drop outs from psychosocial treatment, the resuts were not statistically significant. Disulfiram can also with cocaine by inhibiting its metabolism, which can increase its plasma concentration. It is only used in secondary care and for poly drug abuse with alcohol.

 

Research is also developing an immunotherapeutic vaccine to cocaine, whereby antibodies bind to the drug in the blood stream so that the antibody bound drug cannot cross the blood brain barrier (BBB) and cause psychomotor effects.

 

The main method of treatment for cocaine abuse is psychotherapy and concurrent medications for the withdrawal symptoms.