Source: New Scientist
Date: 23 September 03

Epilepsy drug helps beat cocaine addiction

lines of cocaine

An anti-epilepsy drug has shown promising results for treating cocaine addiction in a preliminary US trial.

Gamma-vinyl-GABA (GVG), also known as vigabatrin, works in part by blocking the craving for cocaine. When combined with counselling, 40 per cent of addicts successfully gave up their habit for the duration of the sixty-day study.

"This is unheard of in addiction treatment," says Stephen Dewey, at the Brookhaven National Laboratory, and one of the study team. "There are no medicines that are effective at blocking cocaine craving in addicts."

Jonathan Brodie, another team member, told New Scientist: "We've given an effective tool to those people who are at the sharp end. It will give them a period of normal behaviour where they are immune to the normal environmental cues that trigger craving. This gives them the opportunity to begin re-building their lives."

But doctors working with cocaine addicts were sceptical. "Cocaine is a recreational drug. The vast majority of people who take cocaine or crack want to continue doing so," says Allan Parry, who runs a drug counselling service in Liverpool, UK. "So in that sense this work is only likely to be relevant to a tiny minority of people. People often give up cocaine because their lifestyle changes or they just grow up."

Pleasure and reward

The trial involved 20 hard-core addicts who had used cocaine heavily for up to 15 years. All said they wanted to give up the drug.

During the first week of the study, the patients received escalating doses of GVG. However, eight patients dropped out within the first ten days of the 28-day treatment period, because they wanted to continue taking cocaine.

Among the 12 remaining patients, eight completed the trial and their dose of GVG was gradually lowered. These eight remained cocaine-free four weeks after their GVG treatment ended. Crucially, the people who stopped using the street drug reported that their craving did not return once they ceased taking GVG.

The researchers are unsure how GVG managed to reduce the cravings for cocaine. In people with epilepsy, GVG appears to increases the amount of GABA - a brain chemical, or neurotransmitter, involved in nerve cell communication. GABA blocks dopamine, another neurotransmitter, which regulates the brain's pleasure and reward centres.

But Parry also questions the design of the study. "For a start, what happened to the patients after the sixty days of monitoring was over?" he asks.

Journal reference: Synapse (DOI: 10.1002/syn.10278)

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