Cocaine Dependence Clinical Trial
Official title:
Psychopharmacology of Novel Medications for Cocaine Dependence - Buspirone
Chronic cocaine use may produce disruption of neurotransmitter functions (including
dopamine). This may in turn contribute to measurable dysfunction in important cognitive and
behavioral processes. Stimulants that enhance dopamine (DA) function may help in treating
cocaine dependence and improving behavioral function -- supporting the notion that these
processes are related. An important step is to understand the subjective, physiological, and
behavioral effects of potential medications for cocaine dependence.
DA-modulating drugs may be targets for pharmacotherapy for substance dependence, and
particularly for stimulant drugs like cocaine, which disrupt normal DA function. Buspirone
is currently the only available dopamine subtype 3 (DA3) approved for human administration,
and is thus a viable investigational compound.
This project proposes to evaluate the DA-modulating effects of buspirone on behavioral
deficiencies related to DA depletion. Accordingly, the project aims to characterize the
effects of buspirone in individuals with cocaine dependence. Employing a daily dosing
designs within an acute stimulant challenge (methylphenidate), the experiment will
characterize the subjective effects, cardiovascular effects, and behavioral effects
(attentional bias to drug cues and risky decision making). The primary hypotheses are that
buspirone will attenuate the increases in subjective drug effects ("stimulated", "like
drug") and behavioral effects (increases in attentional bias and risky decision making) that
are produced by acute methylphenidate administration.
Chronic cocaine use may produce disruption of monoamine systems (including dopamine). This
may in turn contribute to measurable dysfunction in important cognitive and behavioral
processes. Pharmacotherapy with stimulants that enhance dopamine (DA) function has shown
efficacy in treating cocaine dependence and improving behavioral function -- supporting the
notion that these processes are related. In the development of novel pharmacotherapies for
cocaine dependence, an important step is a full characterization of the
psychopharmacological properties of potential medications for cocaine dependence, including
subjective, physiological, and behavioral effects. Selective medications may play a key role
in the modulation of DA neurotransmission by enhancing DA receptor activation.
The D3 receptor is an autoreceptor that may function to control phasic DA activity and
mediate sensitization of DA agonists, thus playing a role in conditioning of drugs of abuse
like cocaine. Growing evidence suggests that D3 receptor antagonists may be targets for
pharmacotherapy for substance dependence, and particularly for stimulant drugs like cocaine,
which disrupt normal DA function. Importantly, administration of D3 antagonists may disrupt
reactivity (attention) to drug cues and attenuate cue-induced craving. Buspirone is
currently the only available D3 antagonist approved for human administration, and is thus a
viable investigational compound.
This project proposes to evaluate the potential pharmacotherapeutic action of the D3
antagonist buspirone. The DA-modulating effects of buspirone may help with affective and
behavioral deficiencies related to DA depletion. Accordingly, the project aims to
characterize the psychopharmacology of buspirone in individuals with cocaine dependence.
Employing chronic dosing designs within an acute stimulant challenge (methylphenidate), the
experiment will be conducted using well-established psychopharmacological methods in order
to characterize the shape and magnitude of chronic pretreatment-mediated change in the
methylphenidate dose-response curve. Measures will include subjective effects,
cardiovascular effects, and behavioral effects (attentional bias to drug cues and risky
decision making). These data will compliment and provide valuable information to clinical
trials using these agents to treat cocaine dependence.
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