Department of Psychiatry, Yale School of Medicine, 1 Church Street, New Haven, CT 06510, USA; Veterans Affairs Medical Center, 950 Campbell Avenue, West Haven, CT 06516, USA.
Veterans Affairs Medical Center, 950 Campbell Avenue, West Haven, CT 06516, USA; Department of Psychiatry, Yale School of Medicine, 300 George Street, New Haven, CT 06511, USA.
Pharmacol Biochem Behav. 2017 Aug;159:55-61. doi: 10.1016/j.pbb.2017.07.002. Epub 2017 Jul 14.
No pharmacotherapies are approved for the treatment of cocaine use disorders (CUD). Behavioral treatments for CUD are efficacious for some individuals, but recovery rates from CUD remain low. Cognitive impairments in CUD have been linked with poorer clinical outcomes. Cognitive enhancing pharmacotherapies have been proposed as promising treatments for CUD. Atomoxetine, a norepinephrine transporter inhibitor, shows potential as a treatment for CUD based on its efficacy as a cognitive enhancer in other clinical populations and impact on addictive processes in preclinical and human laboratory studies. In this randomized, double-blind, crossover study, abstinent individuals with CUD (N=39) received placebo, 40 and 80mg atomoxetine, over three sessions. Measures of attention, response inhibition and working memory; subjective medication effects and mood; and cardiovascular effects were collected. Analyses assessed acute, dose-dependent effects of atomoxetine. In addition, preliminary analyses investigating the modulation of atomoxetine dose effects by sex were performed. Atomoxetine increased heart rate and blood pressure, was rated as having positive and negative subjective drug effects, and had only modest effects on mood and cognitive enhancement.
没有药物疗法被批准用于治疗可卡因使用障碍（CUD）。针对 CUD 的行为治疗对某些个体有效，但 CUD 的康复率仍然很低。CUD 中的认知障碍与较差的临床结果有关。认知增强型药物治疗被认为是治疗 CUD 的有前途的方法。阿托西汀是一种去甲肾上腺素转运体抑制剂，基于其在其他临床人群中作为认知增强剂的功效以及在临床前和人体实验室研究中对成瘾过程的影响，显示出治疗 CUD 的潜力。在这项随机、双盲、交叉研究中，39 名患有 CUD 的禁欲个体接受了安慰剂、40 毫克和 80 毫克阿托西汀，共 3 个疗程。注意力、反应抑制和工作记忆；主观药物作用和情绪；以及心血管作用均进行了测量。分析评估了阿托西汀的急性、剂量依赖性作用。此外，还进行了初步分析，以研究性别对阿托西汀剂量作用的调节。阿托西汀增加了心率和血压，被评为具有积极和消极的主观药物作用，并且对情绪和认知增强只有适度的影响。
