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Cocaine Addiction


GABAPENTIN
(Neurontin®)

What it does: An anticonvulsant which reduces cocaine use, makes cocaine cravings easier to overcome and relapses less severe

How it works: Increases brain GABA, a neurotransmitter in the brain that has a calming effect, increasing relaxation and reducing stress and anxiety

Side effects: Drowsiness, dizziness, headaches, blurred vision, anxiety, heartburn.
For a more complete list of side effects see this NIH page.

Availability: Physician prescription

Research: Raby Wn. Gabapentin Reduces Cocaine use Among Addicts From a Community Sample. J Clin Psychiatry 2004:65:84-86.

For more information: www.nlm.nih.gov/medlineplus/druginfo/meds/a694007.html

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VIGABATRIN
(Sabril®)

What it does: An anti epileptic drug which reduces cocaine cravings

How it works: Increases the amount of the neurotransmitter GABA in the brain

Side effects: Sleepiness, dizziness, weaken, muscle pain, nausea, constipation.
For a more complete list of side effects see this NIH page.

Availability: Physician prescription

Research: American Journal of Psychiatry 2009;166:1269-1277. Randomized, double-blind, placebo-controlled trial of vigabatrin for the treatment of cocaine dependence in Mexican parolees. This study demonstrates the safety and efficacy of short term vigabatrin for cocaine dependence.

For more information: www.nlm.nih.gov/medlineplus/druginfo/meds/a610016.html

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BACLOFEN (Gablofen®; Lioresal®)

What it does: A muscle relaxant found to curb cocaine cravings and reduce use of cocaine especially in chronic, heavy users

How it works: Increases the amount of GABA in the brain, a neurotransmitter that has a calming and relaxing effect

Side effects: Drowsiness, dizziness, weakness, fatigue, nausea, headache, constipation.
For a more complete list of side effects see this NIH page.

Availability: Physician prescription

Research: J Clin Psychiatry 2003:64:1440-1448 Randomized Placebo-Controlled trial for Cocaine dependence Shoptaw,S etc- reprints Shoptaw@friendsresearch.org. Baclofen plus substance abuse counseling significantly reduced cocaine use in recovering addicts compared to placebo plus counseling.

For more information: www.nlm.nih.gov/medlineplus/druginfo/meds/a682530.html

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N-ACETYLCYSTEINE (NAC)

What it does: An amino acid that curbs cocaine cravings and repairs damage in the brain caused by cocaine use in animals

How it works: Restores glutamate levels to normal in the area of the brain where addiction occurs

Side effects: Gastrointestinal disturbance, diarrhea, nausea, vomiting, fatigue, skin rash
For a more complete list of side effects see this web page.

Availability: Over the counter

For specific suggestions of other amino acids that can lessen cravings see our Nutrition page.

For more information: www.mskcc.org/mskcc/html/69310.cfm

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NOCAINE

What it does: Provides a weaker version of cocaine's effects

How it works: Blocks the stimulant effects of cocaine

Side effects: Unknown to us

Availability: Only by participating in research trials

Information about clinical trials on cocaine can be found at ClinicalTrials.gov. Just enter the word cocaine in the "Search Clinical Trials" box.

For more information: explore.georgetown.edu/news/?ID=2914&PageTemplateID=295

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DISULFIRAM (ANATBUSE)

What it does: It is an anti-alcoholic agent that makes drinking of alcohol or use of cocaine highly unpleasant.

How it works: It increases acetaldehyde in the blood

Side effects: Nausea, vomiting (sometimes very severe, if any alcohol or cocaine is used), rapid heart rate, difficulty breathing, low blood pressure, confusion and fainting. For a more complete list of side effects see this NIH page.

Availability: Physician prescription

Research: Research suggests that disulfiram (also known as Antabuse), a medication used to treat alcohol addiction, is effective in reducing cocaine abuse, especially in conjunction with cognitive behavioral therapy.
Carroll KM, et al. "Efficacy of Disulfiram and Cognitive Behavior Therapy in Cocaine-Dependent Outpatients: A Randomized Placebo-Controlled Trial." Archives of General Psychiatry. 61:264-272, 2004.

For more information: www.nlm.nih.gov/medlineplus/druginfo/meds/a682602.html

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MODAFINIL (PROVIGIL)

What it does: Promotes longer total sleep time and decreases daytime sleepiness in abstinent cocaine users

How it works: May increase the release of dopamine in the brain's reward center

Side effects: Anxiety, depression, diarrhea, dizziness, dry mouth, headache. Modafinil should be avoided by people with certain types of heart disease such as mitral valve prolapse.
For a more complete list of side effects see this NIH page.

Availability: Physician prescription

Warning: A schedule 4 drug with potential for addiction

Research: American Journal of Psychiatry. 2010; 167(3):331-40. Normalizing effects of modafinil on sleep in chronic cocaine users. Progressive abstinence from cocaine was associated with worsening sleep. Modafinil taken in the morning produced longer total sleep time and shorter time to fall asleep in the third week of abstinence.

For more information: www.nlm.nih.gov/medlineplus/druginfo/meds/a602016.html