Treatment of Cocaine Addiction

Neurite orientation dispersion and density imaging in cocaine use disorder

“…Cocaine use disorder (CUD) is a worldwide substance use disorder (SUD) with serious consequences for the individual's health and society , as it produces cognitive deficit, including lack of inhibition and compulsive search for cocaine, that may be secondary to brain pathology (Volkow et al, 2019) and, as of today, there are no proven successful treatments (Gorelick, 2015). The microstructural pathology in CUD commonly observed in postsynaptic receptors and dendritic spines, appears to be a consequence of neuroadaptation in neurons located in ventral tegmental area (VTA) and nucleus accumbens (NAc) (Siciliano et al, 08/2015).…”

Clinical and functional connectivity outcomes of 5-Hz repeated transcranial magnetic stimulation as an add-on treatment in cocaine use disorder: a double-blind randomized controlled trial

“…Another explanation for variability in treatment outcome may relate to cortical pathology, as cortical excitability of frontal regions in neuromodulation relies on the microstructural and neurochemical integrity of the cortical layers [66,67], which are altered in CUD [68–70]. Finally, the lack of long-term maintenance may reflect patient-level factors in CUD patients, such as their exposure to consumption triggers and other general treatment-related factors that need to be investigated further [2,3]. Treatment for SUDs is complex and any single strategy is unlikely to be sufficient to reduce consumption.…”

“…Cocaine use disorder (CUD) is characterized by impulsivity and intense craving, with consequent risk-taking and antisocial behavior and health sequelae that can include violence, hospitalizations and death [1]. There are no approved medications for CUD and standard-of-care psychosocial treatments are associated with high dropout rates [2,3]. Accordingly, new treatment approaches are needed; neuromodulation is an attractive contender [4].…”

Pharmacological treatment of psychostimulant use disorders.

“…Most studies have shown the various pharmacotherapies that have been tried to be relatively well tolerated and, certainly, not more severe than the effects of ongoing stimulant use. No significant adverse events have been reported in studies of modafinil or sustained-release dextroamphetamine, suggesting that stimulant substitution treatment may be safe in patients using cocaine (Gorelick, 2014). Common side effects of modafinil include anxiety, nausea, and headache; common side effects of dextroamphetamine include reduced appetite, insomnia, anxiety, and irritability.…”

“…Other common side effects of typical antipsycho tics include constipation, dry mouth, blurred vision, and weight gain. Antidepressant medications have been widely used for decades with no unexpected or medically serious side effects reported in published clinical trials in populations that include users of psychostimulants (Gorelick, 2014). However, there is an increased risk of cardiovascular side effects, especially arrhythmias, if a patient suffers a relapse to stimulant use while taking an antidepressant.…”