Treatment of Cocaine Abuse: Pharmacotherapy

  1. Gregory R. Bock Organizer and
  2. Julie Whelan
  1. Herbert D. Kleber

Published Online: 28 SEP 2007

DOI: 10.1002/9780470514245.ch11

Ciba Foundation Symposium 166 - Cocaine: Scientific and Social Dimensions

Ciba Foundation Symposium 166 - Cocaine: Scientific and Social Dimensions

How to Cite

Kleber, H. D. (2007) Treatment of Cocaine Abuse: Pharmacotherapy, in Ciba Foundation Symposium 166 - Cocaine: Scientific and Social Dimensions (eds G. R. Bock and J. Whelan), John Wiley & Sons, Ltd., Chichester, UK. doi: 10.1002/9780470514245.ch11

Author Information

  1. Office of National Drug Control Policy, Executive Office of the President, Washington, DC 20500, USA

  1. Professor Herbert D. Kleber, Department of Psychiatry, Columbia University College of Physicians & Surgeons, 722 W 168th Street, Box 66, New York, NY 10032, USA.

Publication History

  1. Published Online: 28 SEP 2007

ISBN Information

Print ISBN: 9780471931799

Online ISBN: 9780470514245

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Keywords:

  • pharmacotherapy;
  • cocaine abuse treatment;
  • potential pharmacological agents;
  • potential pharmacotherapies;
  • cocaine withdrawal

Summary

Until recently the treatment of cocaine addicts was limited to non-pharmacological methods because cocaine abuse was viewed as a psychological addiction to the drug's euphoriant effects. Chronic stimulant abuse is now known to lead to neurophysiological adaptation. This physiologica1 evidence, and the failure of many patients to respond adequately to psychological treatment, prompted clinicians and researchers to explore numerous pharmacological agents in the early 1980s. Promising medications that may affect the euphoria, the craving, withdrawal, or the toxic effects associated with cocaine are under development. Potential pharmacological agents being studied include tricyclic antidepressants, anticonvulsants, neurotransmitter precursors, stimulants and dopamine agonists, serotonin re-uptake blockers and agonists, neuroleptics and opioid agonists/antagonists. Most of the research to date is on anti-craving agents. While many positive clinical reports exist, most reports are anecdotal and uncontrolled. The available data are reviewed. Potential pharmacotherapies require further research to elucidate the differences between treatments, the target populations, the optimal dosages and duration, and the interaction with behavioural and psychotherapeutic approaches.