Estimated read time: 3-4 minutes
This archived news story is available only for your personal, non-commercial use. Information in the story may be outdated or superseded by additional information. Reading or replaying the story in its archived form does not constitute a republication of the story.
Knight Ridder Newspapers
(KRT)
PHILADELPHIA - Two of the most intriguing drugs for alcoholism are topiramate (Topamax) and gabapentin (Neurontin), two antiseizure drugs that affect the brain's craving, said Raye Litten of the National Institute on Alcohol Abuse and Alcoholism. An herbal medication derived from the bane of the South - kudzu - reduced drinking in animals, he said.
Topiramate is also considered promising for cocaine addiction. Kyle Kampman, a University of Pennsylvania psychiatrist, is testing it in people addicted to both cocaine and alcohol, a common combination. The compound may reduce pleasure from the drugs and limit craving.
Bankole Johnson, a University of Virginia researcher who has studied the drug in alcoholics, thinks it may also be useful for losing weight and kicking cigarettes.
A downside, Kampman said, is that it can cause significant memory problems.
Anna Rose Childress, a Penn neuroscientist, is studying baclofen, now used to treat spastic disorders. Animal studies show it might benefit those addicted to nicotine and alcohol, she said.
GVG (vigabatrin) is being tested in cocaine and methamphetamine addicts. The epilepsy drug is approved in Europe but not the United States because it can cause vision problems. Its U.S. maker, Catalyst Pharmaceutical Partners, plans to seek initial approval here for cocaine and later for meth addiction. Chief executive officer Patrick McEnany thinks the drug, which regulates production of a neurotransmitter, could ultimately be useful for virtually all addictions.
Charles Dackis, chief of psychiatry at Penn's Medical Center-Presbyterian, is optimistic about modafinil (Provigil), a drug now used to treat narcolepsy and help shift workers stay alert. Its big plus: Addicts liked taking it. While it blunts cocaine euphoria, it also promotes "a sense of well being."
Rimonabant is also drawing attention. Its manufacturer, Sanofi-Aventis, plans to seek approval for the drug this year for cardiovascular risk management. In studies, it helped patients lose weight and stop smoking, which both affect heart health, the company says.
Herbert Kleber, a Columbia University addictions expert, wants to study rimonabant in marijuana and cocaine addicts. The drug works on the brain's cannabinoid receptors, where marijuana and other naturally pleasurable substances link chemically in the brain. Someone who smoked marijuana probably wouldn't feel the high if taking the drug, Kleber said.
Abilify (aripiprazole), an antipsychotic, is intriguing because of its unusual effect on the dopamine system, said Frank Vocci, a medications expert at the National Institute on Drug Abuse. It's being studied in cocaine addiction, and NIDA plans to look at it in methamphetamine use.
The most unusual approach to addiction so far is vaccines. Yale University psychiatrist Thomas Kosten has worked on a cocaine vaccine for a decade. Several private firms are trying to develop a nicotine vaccine, he said.
The body doesn't naturally produce antibodies to cocaine because it's too small a molecule. Kosten's vaccine, now being tested in a large clinical trial, makes cocaine "visible" by attaching it to a genetically modified cholera toxin. (As a side benefit, patients are immune to cholera.) If addicts use cocaine after vaccination, the body recognizes the drug as an invader and neutralizes it before it can cross the blood-brain barrier.
---
ARSENAL FOR ADDICTS
Alcohol
Currently approved: naltrexone, disulfiram (Antabuse), acamprosate (Campral)
Under study: topiramate (Topamax), gabapentin (Neurontin), ondansetron (Zofran), rimonabant
Cocaine
Currently approved: nothing
Under study: baclofen, disulfiram (Antabuse), modafinil (Provigil), topiramate (Topamax), Propranolol (Inderal), aripiprazole (Abilify), vaccine
Heroin
Currently approved: naltrexone, methadone, buprenorphine (Subutex or, with naloxone added, Suboxone)
Under study: long-acting versions of naltrexone and buprenorphine
Nicotine
Currently approved: buprion (Wellbutrin) and nicotine replacement treatments such as the patch.
Under study: rimonabant, vaccines
---
(c) 2005, The Philadelphia Inquirer. Distributed by Knight Ridder/Tribune News Service.
