RESUMEN
Thirteen behavioral variables from six tasks were measured in alcohol-preferring (AA, FH, and P) and -nonpreferring (ANA, FRL, and NP) rat lines/strains and subjected to Factor Analysis. Four Independent factors accounted for > 90% of the variance. Defecation in the open field and ultrasonic vocalizations after an air puff were negatively correlated with alcohol intake and preference, whereas the increase in daily fluid intake in the presence of saccharin was positively correlated. Other factors could be labeled Activity, Emotionality, and immobility Factors, and each was independent of the Alcohol Factor. When an additional alcohol-preferring rat line (HAD) and two additional nonpreferring groups (LAD and ACI) were tested, they were found to differ on most behaviors that were associated with alcohol intake and preference in the Factor Analysis; vocalizations and saccharin-induced increase in fluid intake, but not defection. A new Factor Analysis was then performed incorporating these three new groups and including five new behavioral measures. The following measures had high loadings on the Alcohol Factor: alcohol intake under choice conditions; alcohol preference; forced alcohol intake; alcohol acceptance (forced alcohol intake/basal water intake x 100); ultrasonic vocalization; saccharin intake; saccharin-induced increase in daily fluid intake; defecation in the open field test; and immobility in a modified forced swim test. These findings indicate that there are indeed certain behavioral characteristics that are common among alcohol-preferring rat lines/strains, but there are also substantial group differences on other behavioral measures. For those behavioral measures reflecting emotionality (defecation and ultrasonic vocalization) that loaded highly on the Alcohol Factor, the alcohol-preferring rats had lower scores.
Asunto(s)
Consumo de Bebidas Alcohólicas/genética , Conducta Animal/fisiología , Motivación , Animales , Nivel de Alerta/genética , Emociones/fisiología , Análisis Factorial , Masculino , Actividad Motora/fisiología , Ratas , Ratas Endogámicas , Especificidad de la Especie , Gusto/genéticaRESUMEN
A 12-week, randomized, double-blind, placebo-controlled, fixed-dose outpatient study of carbamazepine (400 mg and 800 mg) in the treatment of cocaine dependence was performed. Data were analyzed with respect to both treatment condition and carbamazepine serum levels. Outcome variables included subject retention, cocaine urinalysis, self-reported cocaine use, cocaine craving, patient and clinical global impressions, the Drug Impairment Rating Scale for Cocaine, and side effects. Compared with placebo, the 400 mg treatment condition exhibited a greater decrease in the rate of positive cocaine urinalyses and a reduction in intensity and duration of craving over the course of the study. Higher serum carbamazepine levels were associated with a lower rate of positive cocaine urinalysis, fewer days of self-reported cocaine use, briefer craving episodes, and greater subject interval retention. The clinical and methodologic implications of these findings and of the study design are discussed.
Asunto(s)
Analgésicos no Narcóticos/uso terapéutico , Carbamazepina/uso terapéutico , Cocaína , Trastornos Relacionados con Sustancias/tratamiento farmacológico , Adulto , Analgésicos no Narcóticos/administración & dosificación , Analgésicos no Narcóticos/efectos adversos , Carbamazepina/administración & dosificación , Carbamazepina/efectos adversos , Estudios Cruzados , Método Doble Ciego , Esquema de Medicación , Femenino , Humanos , Modelos Logísticos , Masculino , Cooperación del Paciente , Encuestas y Cuestionarios , Resultado del TratamientoRESUMEN
The present study investigated the potential benefit of the ethyl ester of N-phenylacetylprolylglycine (GVS-111) on the model of bilateral frontal lobectomy (BFL) in rats. The animals in Experiment 1 were trained in an active avoidance task and subsequently underwent BFL. The animals in Experiment 2 were first assessed in an open field and in a passive avoidance test before the BFL was performed. BFL dramatically decreased performance in the active avoidance test, disturbed habituation of horizontal activity in the open field and diminished the latency to enter the dark compartment in the passive avoidance test. GVS-111, administered in a dose of 0.5 mg/kg/day i.p. for 9 days following the operation, was found to improve performance in both active avoidance and passive avoidance and restored habituation of horizontal activity in the lobectomized animals.
Asunto(s)
Dipéptidos/uso terapéutico , Lóbulo Frontal/fisiología , Discapacidades para el Aprendizaje/tratamiento farmacológico , Trastornos de la Memoria/tratamiento farmacológico , Nootrópicos/uso terapéutico , Animales , Discapacidades para el Aprendizaje/etiología , Discapacidades para el Aprendizaje/psicología , Masculino , Trastornos de la Memoria/psicología , Actividad Motora/efectos de los fármacos , Ratas , Ratas WistarRESUMEN
This 7- to 8-week, multicenter, randomized, double-blind, placebo-controlled study was performed to determine the dose-effect relationship and minimum effective dose for fluvoxamine maleate in a titrated fixed-dose study of major depressive disorder. Gradual titration over 2 weeks to fixed maintenance doses was employed to minimize dropout due to initial side effects. The study enrolled 600 outpatients, male and female, age 18-65, meeting DSM-III-R criteria for major depressive disorder. A 13-item subscore of the standard 21-Item Hamilton Depression Scale was used to minimize the possible contribution of known side effects from serotonin reuptake inhibitors to the overall HAM-D score. Secondary efficacy assessments included the HAM-D retardation factor, HAM-D depressed mood item, CGI-severity of illness item, and SCL depression factor. Fluvoxamine (50-150 mg/day) was therapeutically effective and well tolerated during 6 weeks of therapy. Based on the HAM-D depressed mood item, efficacy was dose dependent. The minimum effective dose was 50 mg/day. Fluvoxamine maleate shows dose-related effectiveness in the acute treatment of major depressive disorder.
Asunto(s)
Trastorno Depresivo/tratamiento farmacológico , Fluvoxamina/administración & dosificación , Inhibidores Selectivos de la Recaptación de Serotonina/administración & dosificación , Administración Oral , Adolescente , Adulto , Anciano , Análisis de Varianza , Relación Dosis-Respuesta a Droga , Método Doble Ciego , Femenino , Humanos , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Pacientes Desistentes del Tratamiento , Escalas de Valoración Psiquiátrica , Índice de Severidad de la Enfermedad , Factores de TiempoRESUMEN
The experiments were designed to study the association between consumption of palatable 0.1% (w/v) saccharin solution, voluntary drinking of 10% (v/v) ethanol solution, and pain sensitivity measured with the hot plate test. Rat lines that were genetically selected for high alcohol consumption (P and AA rats), alcohol-preferring Fawn Hooded (FH) rats and their F2[FH x FRL] hybrids, and the Maudsley Nonreactive strain (MNRA) had a high propensity to consume saccharin that resulted in a significant (almost twofold; p < 0.05) increase in their daily fluid intake when saccharin was available. These strains also had lower pain thresholds in the hot plate test than did their parallel strains [NP, ANA, Maudsley Reactive (MR)]. Most alcohol-nonpreferring strains [NP, ANA, and Flinders Resistant Line (FRL)] had preference ratios for saccharin about as high as those of the alcohol-preferring rats but, unlike the high alcohol drinkers, they did not increase their total fluid intake when saccharin was available. The mean saccharin intakes of the lines were strongly correlated with their alcohol drinking during the first 5 days, whereas their latencies on the hot plate were inversely related to their change in alcohol drinking with experience. The results are consistent with an endogenous opioid mechanism being involved in alcohol drinking.
Asunto(s)
Consumo de Bebidas Alcohólicas/psicología , Dolor/psicología , Sacarina/farmacología , Edulcorantes/farmacología , Gusto/efectos de los fármacos , Consumo de Bebidas Alcohólicas/tratamiento farmacológico , Consumo de Bebidas Alcohólicas/genética , Animales , Dolor/genética , Dimensión del Dolor/efectos de los fármacos , Ratas , Ratas Endogámicas , Tiempo de Reacción/efectos de los fármacos , Tiempo de Reacción/fisiología , Especificidad de la Especie , Gusto/genéticaRESUMEN
Previous reports have provided mixed results about emotional states in rats that voluntarily drink substantial amounts of alcohol. The purpose of the present study was to compare several strains of alcohol-preferring rats (P, AA, FH) with several strains of alcohol-nonpreferring rats (NP, ANA, FRL), and the Maudsley strains on tests reflecting anxiety and immobility. At about 70 days of age the rats were placed in the elevated plus maze for a 5-min test; a forced swim test of 10 min was given 4 days later and this test was followed 4 days later by a modified forced swim test (the capsule), in which there were four false escape alleys. The FRL rats spent more time in the open arms of the elevated plus maze than any other strain, but there was no consistent relationship between elevated plus maze scores and alcohol intake. The alcohol-preferring P rats were the most active in the standard forced swim test and the alcohol-nonpreferring Maudsley Reactive rats were the least active, but there was no consistent relationship between immobility and alcohol intake overall. All rats were much more active in the capsule and there were no significant strain differences. However, the alcohol-preferring P and FH rats attempted to escape more than the other strains, resulting in an overall significant correlation between escape attempts and alcohol intake. These findings do not provide any support for the hypothesis that alcohol-preferring rats are drinking alcohol to reduce high anxiety states.
Asunto(s)
Consumo de Bebidas Alcohólicas/psicología , Ansiedad/psicología , Nivel de Alerta , Actividad Motora , Animales , Depresión/psicología , Reacción de Fuga , Masculino , Aprendizaje por Laberinto , Orientación , Ratas , Ratas Endogámicas , Especificidad de la Especie , NataciónRESUMEN
High open field activity has been associated with high alcohol intake in inbred mouse strains. The present study sought to determine if a similar relationship might exist in rats. Strains which voluntarily drink large amounts of alcohol (alcohol-preferring [P], alcohol-accepting [AA], Fawn-Hooded [FH]) or little or no alcohol (alcohol-nonpreferring [NP], alcohol-nonaccepting [ANA], Flinders Resistant Line [FRL]) were compared with the Maudsley strains of rats selectively bred for differences in open field defecation and activity. There were highly significant strain differences in open field activity, with the alcohol-preferring P rats exhibiting the highest activity and the alcohol-nonpreferring Maudsley Reactive rats exhibiting the lowest. However, the NP rats were almost as active as the P rats and the AA and ANA rats exhibited intermediate levels of activity which did not differ from each other. Thus, there was no consistent relationship between open field activity and high voluntary alcohol intake. Defecation was highest in the Maudsley Reactive rats, and there was a consistent negative relationship with alcohol intake (r = -0.455 across all strains). In a population of 57 FHxFRL F2 hybrids, there were no significant correlations between alcohol intake and open field activity (r = -0.01) or defecation (r = +0.12). We conclude, therefore, that there was no consistent relationship between voluntary alcohol intake and open field behavior across strains of rats.
Asunto(s)
Consumo de Bebidas Alcohólicas , Locomoción/efectos de los fármacos , Animales , Conducta Animal , Defecación , Ratas , Especificidad de la EspecieRESUMEN
This article serves as an introduction to the treatment of the various drug abuse syndromes. The theoretical concept underlying all diagnoses in drug dependence is presented first in detail, along with an extensive discussion of how these diagnoses are operationalized. Tolerance and dependence among the various drugs of abuse are considered. The review of treatment approaches divides drugs of abuse into pharmacologic categories and treatment into time segments, acute detoxification, intermediate-term, and long-term treatment. Pharmacotherapies for each of the categories of substance abuse and for each of the time periods are presented in a treatment-oriented fashion. Drug substitution therapy is considered. Individual and group therapy are discussed, as is education in the form of group process and peer feedback. The role of peer support groups is stressed. Finally, patient placement criteria across levels of care are explained.
Asunto(s)
Drogas Ilícitas , Psicotrópicos , Trastornos Relacionados con Sustancias/rehabilitación , Alcoholismo/psicología , Alcoholismo/rehabilitación , Terapia Combinada , Humanos , Pronóstico , Centros de Tratamiento de Abuso de Sustancias , Síndrome de Abstinencia a Sustancias/rehabilitación , Trastornos Relacionados con Sustancias/psicologíaRESUMEN
Experiments replicated the previous finding that rats with high immobilization time in the forced swim test (passive rats) consumed more 15% ethanol solution in a free choice situation with tap water than rats with active behavior (active rats). Exposure of passive rats to oxygen under normal and elevated (2 ata) pressure resulted in the decrease in immobilization scores in the forced swim test as well as reduction in alcohol consumption and preference.
Asunto(s)
Etanol/administración & dosificación , Trastornos del Movimiento/prevención & control , Oxígeno/uso terapéutico , Natación , Consumo de Bebidas Alcohólicas , Animales , Oxigenoterapia Hiperbárica , Masculino , Trastornos del Movimiento/etiología , RatasRESUMEN
Saccharin and ethanol intakes were measured in seven strains of rats known to differ in their preferences for ethanol: The Fawn-Hooded (FH), alcohol-preferring (P) and Maudsley Reactive rats have been reported to drink ethanol voluntarily, whereas the alcohol-nonpreferring, Maudsley Nonreactive and Flinders Line (FSL and FRL) rats do not. Saccharin and ethanol intakes were highly correlated (r = +0.61) over all strains, with the FH rats drinking the most of both solutions. Correlation coefficients between pairs of drinking versus nondrinking rat strains were even higher. In a second experiment, genetically heterogeneous F2 progeny from cross-breeding the ethanol-preferring FH rats with the ethanol-nonpreferring Flinders Resistant Line (FRL) rats were studied. The results indicated a high positive correlation between saccharin and ethanol intakes (+0.65). These findings suggest that the association between saccharin and ethanol intakes previously reported in rat strains with different preferences for ethanol may have a similar genetic basis.
Asunto(s)
Consumo de Bebidas Alcohólicas/genética , Nivel de Alerta/genética , Ingestión de Líquidos/genética , Genotipo , Sacarina/administración & dosificación , Gusto/genética , Animales , Masculino , Ratas , Ratas Endogámicas , Especificidad de la EspecieRESUMEN
Various medication therapies have been attempted to assist in detoxification and abstinence maintenance among cocaine users. The safety of these medications in this unique population has not been documented. Carbamazepine, an anticonvulsant being used with this population, is known to cause leukopenia and agranulocytosis in seizure patients. Analysis of data involving two different populations of cocaine users treated with carbamazepine revealed no statistically or clinically significant changes in total white blood cell count, or in any component white cell, using endpoint analysis, lowpoint analysis, or regression analysis. These results should be reassuring to the addiction medicine clinician.
Asunto(s)
Carbamazepina/efectos adversos , Cocaína , Recuento de Leucocitos/efectos de los fármacos , Trastornos Relacionados con Sustancias/sangre , Adolescente , Adulto , Carbamazepina/uso terapéutico , Cocaína Crack , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastornos Relacionados con Sustancias/tratamiento farmacológicoRESUMEN
In order to assess the usefulness of pharmacotherapeutic agents in cocaine treatment, all 3,631 physician members of the American Society of Addiction Medicine (ASAM) were surveyed. Five hundred and two physicians indicated use of pharmacotherapies, involving treatment experiences with approximately 79,760 patients for cocaine detoxification, and with 37,166 patients for cocaine abstinence maintenance. For both detoxification and abstinence maintenance, the four most commonly prescribed medications were amantadine, bromocriptine, desipramine, and l-tryptophan. As expected, these four medications were also the preferred treatment by a majority of physicians expressing any preference. Some relatively new medications are also being tried for the treatment of cocaine abuse, specifically carbamazepine, fluoxetine, and Tropamine.
Asunto(s)
Cocaína , Psicotrópicos/uso terapéutico , Trastornos Relacionados con Sustancias/rehabilitación , Actitud del Personal de Salud , Cocaína/efectos adversos , Cocaína/antagonistas & inhibidores , Humanos , Síndrome de Abstinencia a Sustancias/tratamiento farmacológicoRESUMEN
No pharmacological treatment protocol has proven generally useful for all patients who stutter. Various medications, behavior therapy, relaxation, suggestion, and social-based therapies have been used. For this drug treatment study, two groups of adult stutterers were followed in an 8-week open label protocol. All subjects had in the past received speech therapy; none had been treated previously with medication for stuttering. The first group (N = 12) received a maximum dose of 800 mg of carbamazepine; the second group (N = 8) received a maximum dose of 400 mg of carbamazepine. Each patient served as his or her own control. A series of systematic speech tests was given weekly to determine the variability of fluency for each subject. A statistically significant change occurred for a number of "expectancy to stutter" characteristics. Subjects felt that they stuttered less often while taking carbamazepine. Subjective effects began before medication and continued after patients discontinued the medication. Struggle characteristics also subjectively decreased. However, no objective improvement was found. No change was found in percentage of words stuttered, reading improvement, or improvement in spontaneous speech rate. Interrater reliability showed a correlation of .996. Three carbamazepine serum level therapeutic windows were inspected with negative results. Interestingly, naive listener ratings did show a statistically significant improvement on carbamazepine versus placebo. Future anecdotal reports of pharmacological improvement of stuttering should be subjected to rigorous objective testing before general acceptance.
Asunto(s)
Carbamazepina/uso terapéutico , Tartamudeo/tratamiento farmacológico , Adulto , Actitud Frente a la Salud , Carbamazepina/administración & dosificación , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Inventario de Personalidad , Placebos , Habla , Tartamudeo/psicología , Grabación en CintaRESUMEN
The Halikas-Crosby Drug Impairment Rating Scale for Cocaine (HAL DIRS-C) is designed to measure improvement in drug treatment through interval assessment of impact of cocaine use on daily functioning, relationships with other people, other alcohol and drug use, cocaine withdrawal symptoms, adverse effects associated with cocaine use, and personal outlook over the previous week. The scale is a 25-item clinical rating scale administered in the context of a semistructured interview (modeled after and similar to the Hamilton Rating Scale for Depression). The HAL DIRS-C was administered weekly to 147 subjects participating in a 12-week, double-blind medication trial with a psychosocial treatment component. Without breaking the pharmacologic blind, the HAL DIRS-C score was found to be significantly related to study retention, ongoing psychosocial treatment participation, urinalysis results, and other measures of outcome. The results support the validity of the HAL DIRS-C as a standardized measure of improvement or outcome in clinical research involving the treatment of cocaine abuse.
Asunto(s)
Cocaína , Trastornos Relacionados con Sustancias/psicología , Adulto , Método Doble Ciego , Femenino , Humanos , Masculino , Escalas de Valoración PsiquiátricaRESUMEN
In order to assess increased creatinine phosphokinase (CPK) among medically asymptomatic active crack cocaine abusers, retrospective analysis of daily supervised urine data collected in a 20 day daily visit plus 12 week followup weekly visit study of heavy crack cocaine abusers was performed. The subjects were 36 black male chronic crack cocaine users unmotivated in drug abuse treatment, willing to be studied for daily payment, who were recruited by word of mouth on the street. Of the 464 CPK results obtained, the mean CPK value was 397 (SD = 784) IU/L. Two-thirds of the results were greater than 200; 19% were greater than 500 IU/L. CPK test results were systematically eliminated if related to medical causes or concurrent other drug use. The relative contribution of recent alcohol use versus recent cocaine use in raising CPK was assessed by dividing the remaining 435 observations into sequential use groups. With alcohol use instances excluded, a statistically significant relationship between urine cocaine metabolite and elevated CPK was found. When all other possible causes of elevated CPK levels were controlled, crack cocaine use was associated with a significant quantitative effect on CPK level.
Asunto(s)
Cocaína/efectos adversos , Creatina Quinasa/análisis , Trastornos Relacionados con Sustancias/complicaciones , Adulto , Cocaína/metabolismo , Creatina Quinasa/orina , Método Doble Ciego , Humanos , Masculino , Enfermedades Metabólicas/clasificación , Enfermedades Metabólicas/etiología , Psicosis Inducidas por Sustancias , Estudios Retrospectivos , Rabdomiólisis/etiologíaRESUMEN
Crack is a rock crystalline alkaloid form of cocaine which can be smoked. At the University of Minnesota, we have developed an experimental pharmacologic treatment for cocaine abusers. Of 26 patients treated to date, 16 have been crack cocaine users. During the hundred days preceding treatment, the 16 crack subjects used cocaine by all routes an average of 71 days each. Improvement was based on a self-reported decrease in cocaine frequency of use. Using carbamazepine, seven highly successful and six partially successful patients reduced their use to 0.7 days and 26 days per 100 days, respectively. These results, though hopeful, must be viewed with caution and considered preliminary and tentative.
Asunto(s)
Carbamazepina/uso terapéutico , Cocaína Crack , Trastornos Relacionados con Sustancias/rehabilitación , Adulto , Cocaína Crack/efectos adversos , Centros de Día , Femenino , Estudios de Seguimiento , Dependencia de Heroína/rehabilitación , Humanos , Masculino , Metadona/uso terapéutico , Centros de Tratamiento de Abuso de Sustancias , Abuso de Sustancias por Vía Intravenosa/rehabilitación , Síndrome de Abstinencia a Sustancias/rehabilitaciónRESUMEN
On the basis of cocaine-caused kindling in animals and the usefulness of carbamazepine in treating kindling-type seizures, carbamazepine has been tried in clinical settings with cocaine-dependent individuals. This report presents findings of a 20-day, double-blind, placebo-controlled crossover study in 32 nontreatment-motivated, paid, chronic crack cocaine users. Carbamazepine significantly lowered the mean number of positive urine specimens compared with placebo. Of clinical importance, serum carbamazepine levels of 4 micrograms/ml (17 mumol/L) or more were associated with greater improvement. A consistent, clinically important trend linked therapeutic levels with improvement for all subjective and objective outcome variables. Comparison of daily acknowledged cocaine use or professed cocaine abstinence, with cocaine use indicated by daily urinalysis in these chronic cocaine users, has suggested the possibility of cocaine saturation as an important methodologic limitation inherent in outpatient studies of cocaine use in humans.
Asunto(s)
Carbamazepina/uso terapéutico , Cocaína , Trastornos Relacionados con Sustancias/tratamiento farmacológico , Administración Oral , Adulto , Carbamazepina/sangre , Cromatografía Líquida de Alta Presión , Método Doble Ciego , Escolaridad , Humanos , Masculino , Matrimonio , Persona de Mediana Edad , Motivación , Trastornos Relacionados con Sustancias/psicología , Trastornos Relacionados con Sustancias/orinaRESUMEN
The prevalence of substance abuse and coexisting DSM-III psychiatric disorders was evaluated in 111 juvenile offenders. As expected, a high rate of conduct disorder (91%) was present in both substance abusing and nonsubstance abusing juvenile offenders. However, significantly higher rates of attention deficit disorder and aggressive subtype of conduct disorder were present in those offenders who abused drugs and alcohol (54%). Excluding all conduct and oppositional disorder diagnoses, 39% of substance abusers versus 14% of the nonsubstance abusers demonstrated comorbid psychiatric diagnoses. These findings suggest that careful psychiatric evaluation of juvenile substance abusers may be necessary to optimize treatment planning.
Asunto(s)
Alcoholismo/psicología , Drogas Ilícitas , Delincuencia Juvenil/psicología , Trastornos Relacionados con Sustancias/psicología , Adolescente , Alcoholismo/rehabilitación , Trastorno por Déficit de Atención con Hiperactividad/complicaciones , Trastorno por Déficit de Atención con Hiperactividad/psicología , Femenino , Humanos , Delincuencia Juvenil/legislación & jurisprudencia , Masculino , Determinación de la Personalidad , Psicopatología , Trastornos Relacionados con Sustancias/rehabilitaciónRESUMEN
The Halikas-Crosby Drug Impairment Rating Scale for Cocaine (HAL DIRS-C) is designed to measure the adverse impact of cocaine use upon life functioning over the previous week. The HAL DIRS-C demonstrated excellent split-half and interrater reliability. Internal consistency of the HAL DIRS-C was shown to be high. All items correlated significantly with total score and loaded on a single factor. The HAL DIRS-C correlated significantly with self-reported cocaine use, craving for cocaine, and independent ratings of the severity of addiction. The HAL DIRS-C was found to be sensitive to clinical change across weekly administrations. The scale is brief, easy to administer, and both interviewer and client-friendly. Our results suggest that the HAL DIRS-C may be useful as a standardized measure of improvement or outcome in clinical research involving the treatment of cocaine abuse.
Asunto(s)
Cocaína , Evaluación de Resultado en la Atención de Salud , Escalas de Valoración Psiquiátrica , Trastornos Relacionados con Sustancias/terapia , Adulto , Femenino , Humanos , Masculino , Reproducibilidad de los ResultadosRESUMEN
The therapeutic management of the cocaine addict deals with a wide range of physical and psychological withdrawal symptoms, including a sometimes overwhelming craving for cocaine. Many medications have been used in the treatment of cocaine withdrawal and dependence, using as a rationale, known pharmacologic effects of cocaine on neurotransmitters. Animal observations related to dopamine depletion, receptor supersensitivity, cocaine-induced kindling, and serotonin depletion have all generated pharmacotherapeutic interventions for cocaine abuse. An extensive review of the use of these agents is presented. Pharmacotherapeutic strategies in dealing with the methadone-maintained cocaine abuser are considered. Future areas of interest and limitations of pharmacotherapy in dealing with cocaine abuse are discussed.