Bromocriptine in cocaine withdrawal--does it work?

Heavy cocaine use has been reported to lead to dopamine depletion in the brain, which in turn may be responsible for strong cocaine craving after withdrawal. Bromocriptine, a dopaminergic agonist, was used on that basis to prevent relapses in the withdrawal period. In an uncontrolled trial of 25 heavy cocaine users, measurements of pre- and post-bromocriptine serum prolactin levels-as indicators of inhibitory dopaminergic control-did not suggest dopamine depletion. Moreover, in 13 of these 25 patients, an assessment scale for craving and for other subjective discomforts indicated some improvement in only a slight majority, which is probably inseparable from placebo effect.