Cocaine Addiction

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

J Clin Psychiatry 2003:64:1440-1448. Randomized placebo-controlled trial for cocaine dependence. Shoptaw S, et al. Baclofen plus substance abuse counseling significantly reduced cocaine use in recovering addicts compared to placebo plus counseling.

Neuropsychopharmacology. 2006 Aug; 31(8):1814-21. Effects of baclofen on cocaine self-administration: opioid- and nonopioid-dependent volunteers. Haney M, Hart CL, Foltin RW. Baclofen decreased cocaine use in nonopioid-dependent patients seeking treatment for cocaine dependence but may not be effective in opioid-dependent cocaine users such as those on methadone.

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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.

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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 when combined 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.

Disulfiram was shown to be effective in six randomized clinical trials for the treatment of cocaine dependence but is rarely used in clinical settings because of safety concerns. When patients are screened for medical and psychiatric stability and are evaluated for drug interactions, disulfiram has an acceptable side-effect profile for the treatment of cocaine dependence with or without alcohol dependence.                                                                         

Malcolm R, et al. The safety of disulfiram for the treatment of alcohol and cocaine dependence in randomized clinical trials: guidance for clinical practice. Expert Opin Drug Saf. 2008 Jul;7(4):459-72.

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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: As people stop using cocaine, it is often 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.  Morgan PT.  Normalizing effects of modafinil on sleep in chronic cocaine users.  American Journal of Psychiatry. 2010; 167(3):331-40

In a study of 219 patients dependent on cocaine, modafinil in combination with individual behavioral therapy increased the number of days cocaine was not used in patients who were not dependent on alcohol and in reduced cocaine craving. Anderson AL, et al.  Modafinil for the treatment of cocaine dependence.  Drug and Alcohol Dependence. 2009 Sept 1; 104(1-2): 133.

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Updated May 23, 2018