Cocaine Dependence Clinical Trial
Official title:
Vigabatrin for Treatment of Cocaine Dependence: A Phase II Study
The objective of this study is to demonstrate that a larger proportion of vigabatrin-treated subjects than placebo-treated subjects will be cocaine-free in the last 2 weeks of treatment.
Cocaine addiction, a serious public health concern associated with significant medical,
social, and economic consequences, is difficult to treat using traditional psychosocial and
behavioral therapies. Despite testing of a number of different agents for cocaine dependency,
there remains no proven pharmacologic treatment for cocaine addiction.
The addictive properties of cocaine have been associated with its actions on
mesotelencephalic dopamine reward pathways in the central nervous system (CNS). Cocaine
administration increases the levels of dopamine, a neurotransmitter associated with
sensations of pleasure and reward. Therefore, blocking cocaine-induced increases in dopamine
levels represents a valid pharmaceutical approach to the treatment of cocaine addiction.
Another neurotransmitter, gamma-aminobutyric acid (GABA), suppresses striatal dopamine
release, and attenuates cocaine-induced increases in extracellular and synaptic dopamine
levels in the striatum and nucleus accumbens in animal models of drug dependence. Significant
elevation of brain GABA levels may reduce cocaine-stimulated dopamine release and dampen the
sensations of pleasure and reward. Thus, drugs that potentiate or enhance GABA-ergic
transmission are candidates for the treatment of cocaine addiction.
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