Pharmacotherapy of Dual Substance Abuse and Dependence

@article{Kenna2007PharmacotherapyOD,
  title={Pharmacotherapy of Dual Substance Abuse and Dependence},
  author={George A. Kenna and Darci M. Nielsen and Patricia Gaspar Mello and Alison Schiesl and R. M. Swift},
  journal={CNS Drugs},
  year={2007},
  volume={21},
  pages={213-237}
}
The US FDA has approved a limited number of treatments for alcohol, nicotine and opioid dependence; however, no treatments for other abused drugs such as marijuana, cocaine or methamphetamine are approved. This review focuses on research into drug pharmacotherapies, particularly single-drug therapies, for substance abuse and dependence contributing to the most important dual substance use disorders (SUDs). Given the implications of poly-substance abuse, it is essential that clinicians and… 
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References

SHOWING 1-10 OF 198 REFERENCES
Client issues in drug abuse treatment: addressing multiple drug abuse.
  • T. Kosten
  • Psychology, Medicine
    NIDA research monograph
  • 1991
TLDR
Few controlled clinical trials are available with multiple drug abusers, but successful treatments using pharmacological adjuncts such as disulfiram and amantadine have been described with cocaine-abusing or alcoholic methadone-maintained patients.
Disulfiram treatment for cocaine dependence in methadone-maintained opioid addicts.
TLDR
Disulfiram may be an effective pharmacotherapy for cocaine abuse among methadone-maintained opioid addicts, even in those individuals without co-morbid alcohol abuse.
Novel Approaches to the Treatment of Cocaine Addiction
TLDR
This review summarises some of the emerging targets for cocaine pharmacotherapy including dopaminergic and GABA medications, adrenoceptor antagonists, vasodilators and immunotherapies, and a cocaine vaccine, which act on neural pathways.
Increasing treatment options for cannabis dependence: a review of potential pharmacotherapies.
  • C. Hart
  • Biology, Medicine
    Drug and alcohol dependence
  • 2005
Rationale for use of aripiprazole for alcohol dependence treatment
TLDR
Animal and human data suggest that aripiprazole -a dopamine/5-HT system stabilizer- possesses several important mechanisms of action that target specific dopamine and 5-HT receptors, with a more acceptable side effect profile.
Treatment of cocaine-alcohol dependence with naltrexone and relapse prevention therapy.
TLDR
In conclusion, NTX at 50 mg/d did not reduce cocaine or alcohol use, stand in contrast to previously reported positive findings for NTX and RP in patients with a single diagnosis of cocaine dependence.
Fluoxetine is ineffective for treatment of cocaine dependence or concurrent opiate and cocaine dependence: two placebo-controlled double-blind trials.
TLDR
Two complementary studies demonstrate that fluoxetine is ineffective in reducing cocaine use or craving and points to setting conditions modulating treatment outcome.
Understanding polydrug use: review of heroin and cocaine co-use.
TLDR
Clinical and preclinical experimental evidence indicates that the simultaneous administration of cocaine and heroin does not induce a novel set of subjective effects, nor is it more reinforcing than either drug alone, especially when the doses of heroin and cocaine are high.
Medications development: successes and challenges.
Pharmacologic treatments for heroin and cocaine dependence.
  • H. Kleber
  • Psychology, Medicine
    The American journal on addictions
  • 2003
TLDR
The use of medication in the context of general principles of opioid and cocaine addiction treatment is discussed, and both established medications and promising directions in pharmacotherapy will be addressed.
...
1
2
3
4
5
...