Karila Laurent, Weinstein Aviv, Benyamina Amine, Coscas Sarah, Leroy Claire, Noble Florence, Lowenstein William, Aubin Henri-Jean, Lépine Jean-Pierre, Reynaud Michel
Université Paris-Sud, F-94276 Le Kremlin Bicêtre, France.
Presse Med. 2008 Apr;37(4 Pt 2):689-98. doi: 10.1016/j.lpm.2007.08.015. Epub 2007 Dec 21.
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, dopaminergic, and glutamatergic systems, as well as immunotherapy, show promise in the treatment of cocaine addiction. Recent controlled clinical studies have tested some of these drugs, which act on the various neurobiological circuits modified by cocaine exposure and clinically improve patients' symptoms. Pharmacological agents such as modafinil, 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.
可卡因在法国的使用和滥用现象日益严重。可卡因成瘾相当严重，并伴有众多不良健康后果。目前尚无治疗可卡因成瘾的有效药物疗法。神经生物学、脑成像方面的最新进展以及一些临床试验表明，某些调节γ-氨基丁酸能、多巴胺能和谷氨酸能系统的药物以及免疫疗法，在治疗可卡因成瘾方面显示出前景。近期的对照临床研究已对其中一些药物进行了测试，这些药物作用于因接触可卡因而改变的各种神经生物学回路，并在临床上改善了患者的症状。诸如莫达非尼、γ-氨基丁酸能药物（巴氯芬、托吡酯、噻加宾和氨己烯酸）、双硫仑、阿立哌唑、N-乙酰半胱氨酸和可卡因疫苗等药物在治疗可卡因成瘾方面似乎很有前景。然而，这必须在更大规模的患者群体中得到证实。
