Current pharmacotherapies and immunotherapy in cocaine addiction

Cocaine is more and more used and abused in France. Cocaine dependence is quite serious and is associated with numerous adverse health consequences. No effective pharmacotherapy for cocaine dependence is yet available. Recent advances in neurobiology, brain imaging and some clinical trials suggest that certain medications that modulate GABAergic, dopominergic, and glutamatergic systems, as well as immunotherapy show promise in the treatment of cocaine addiction. Recent controlled clinical studies hove tested some of these drugs, which act on the various neurobiologicol circuits modified by cocaine exposure Grid clinically improve patients' symptoms. Pharmacological agents such as modofinil, GABAergic agents (baclofen, topiramate, tiagabin, and vigabatrin), disulfiram, aripiprazole, N-acetylcysteine and cocaine vaccine seem very promising in the treatment of cocaine dependence. However this must be confirmed in larger patient populations.