Stimulants: Some Pharmacological Treatments

Question 1

what % of people from Ontario identified cocaine as one of the primary substances for which they are seeking treatment - how does it compare to other drugs?

Answer 1

• 17%

- cocaine is the 3rd most commonly identified reason for seeking treatment (alcohol is the first)

Question 2

where was methamphetamine on the list of the Drug Abuse Warning Network (DAWN)

Answer 2

• it was the fourth most mentioned illicit drug in ED - following cocaine, cannabis and heroin
• 6% of all US treatment admissions

Question 3

how do anti-psychotics d=do with the treatment of stimulants?

Answer 3

• anti-psychotics are dopamine blocking medications so theoretically this would work bc there would be no pleasure from taking the drug but in addition to being uniformly considered dysphoric and unpleasant, the dopamine blocking, antipsychotic drugs produce a number of undesirable and potentially serious side effects (catalepsy, motor tics)
• the older generation of dopamine blocking agents have no usefulness in the treatment of stimulant abuse

Question 4

GABA neurons and the VTA

Answer 4

• use a drug that prevents the breakdown of GABA or enhances GABA in the VTA
• this should lead to greater inhibition of dopamine release in the NAcc and less pleasure from the stimulant - this has not been shown to work

Question 5

Gamma vinyl-GABA

Answer 5

• Vigabatrin (anti-epilepsy drug) impedes the breakdown of GABA - but was not shown to be successful

Question 6

Baclofen

Answer 6

• GABA agonist used to control muscle spasticity

- doesn’t work

Question 7

“Vaccine”

Answer 7

• reduce the effects of administered cocaine
• essentially the vaccine is a cocaine analog that results in the production of cocaine antibodies
• essentially when cocaine is administered after the vaccine the cocaine molecules bond to the antibody and is unable to cross the blood-brain barrier
• this doesn’t work bc the person would just take a larger dose of cocaine to overpower the immunization