Department of Psychiatry, Perelman School of Medicine, Center for Studies of Addiction, University of Pennsylvania, 3535 Market Street, Suite 500, Philadelphia, PA 19104, USA. Email:
Sci Adv. 2019 Oct 16;5(10):eaax1532. doi: 10.1126/sciadv.aax1532. eCollection 2019 Oct.
Cocaine use continues to be a serious worldwide public health problem. Cocaine abuse is associated with substantial morbidity and mortality. Cocaine overdose deaths are increasing in the United States and, in certain populations, outnumber heroin and opiate overdose deaths. Psychosocial treatments remain the treatments of choice for cocaine use disorder (CUD), with standard approaches including contingency management and cognitive behavioral therapy. However, the effect sizes of these treatments are not large, and they are not effective for most patients. Consequently, investigators have sought to develop pharmacological agents to augment the efficacy of psychosocial treatments. Despite these efforts, no medications have yet been proven to be safe and effective for the treatment of CUD. The most promising pharmacological strategies for CUD treatment thus far include the use of dopamine agonists, such as long-acting amphetamine and modafinil or glutamatergic and GABAergic agents such as topiramate. Combination drugs may be especially promising.
可卡因的使用仍是一个严重的全球性公共卫生问题。可卡因滥用与大量发病率和死亡率相关。在美国，可卡因过量死亡人数正在增加，在某些人群中，超过了海洛因和鸦片类药物过量死亡人数。心理社会治疗仍然是可卡因使用障碍（CUD）的首选治疗方法，标准方法包括依情况处理和认知行为疗法。然而，这些治疗方法的效果并不显著，对大多数患者无效。因此，研究人员一直在寻找药理学药物来增强心理社会治疗的效果。尽管有这些努力，但目前还没有药物被证明对治疗 CUD 是安全有效的。迄今为止，治疗 CUD 最有前途的药理学策略包括使用多巴胺激动剂，如长效苯丙胺和莫达非尼，或谷氨酸能和 GABA 能药物，如托吡酯。联合药物可能特别有前途。
