A single dose of Ritalin may cure cocaine addiction
Cocaine is a highly addictive stimulant drug, but ironically, new research suggests that another stimulant may actually help cure cocaine addiction.
Just a single dose of Ritalin was found to modify connectivity in some of the brain circuits linked to craving and self-control among cocaine addicts, according to a study published June 26 in JAMA Psychiatry.
Ritalin (methylphenidate) is a stimulant medication used to treat Attention Deficit Disorder (ADD), which works by raising dopamine and norepinephrine activity in the brain. Prior studies have shown how oral methylphenidate normalizes task-related regional brain activity and associated behavior in cocaine users.
While cocaine also raises dopamine levels in the brain, oral Ritalin takes longer than cocaine to reach peak effect, which therefore reduces the risk of abuse. In other words, Ritalin extends dopamine activity in the brain; thus, improving communication between the brain’s neurotransmitters, which leads to improved cognitive functioning, including attention and information processing.
"Orally administered methylphenidate increases dopamine in the brain, similar to cocaine, but without the strong addictive properties,” said study leader, Rita Goldstein, PhD, Professor of Psychiatry at Mount Sinai.
“We wanted to determine whether such substitutive properties, which are helpful in other replacement therapies such as using nicotine gum instead of smoking cigarettes or methadone instead of heroin, would play a role in enhancing brain connectivity between regions of potential importance for intervention in cocaine addiction," explained Goldstein.
Another researcher involved in the study said that stimulants, like Ritalin, can improve cognitive functioning in areas of the brain that have been impaired by drug addiction.
"Using fMRI, we found that methylphenidate did indeed have a beneficial impact on the connectivity between several brain centers associated with addiction," said first author, Anna Konova.
For the study, 18 cocaine addicts were randomly selected into two groups:
1. The oral dose of methylphenidate group
2. The oral dose of placebo group
The research team then used fMRI (functional magnetic resonance imaging) to examine the strength of the connections in parts of the brain that are associated with addiction.
Imaging scans were conducted both before and during the time the drug reached its peak effects. The researchers also assessed each study participant to determine the severity of their cocaine addiction in an effort to learn if it had any bearing on the results.
In addition, the fMRI scans showed that methylphenidate improved connectivity between a number of areas of the brain that regulate emotions and self-control that are disrupted in those addicted to cocaine.
"The benefits of methylphenidate were present after only one dose, indicating that this drug has significant potential as a treatment add-on for addiction to cocaine and possibly other stimulants,” said Goldstein. “This is a preliminary study, but the findings are exciting and warrant further exploration, particularly in conjunction with cognitive behavioral therapy or cognitive remediation."
Another exciting development on the horizon is an anti-cocaine vaccine. Researchers from Weill Cornell Medical College report that a new anti-cocaine vaccine was successfully tested on primates. In the study, published last May in the journal Neuropsychopharmacology, the researchers say they believe that human clinical trials are not far off.
"The vaccine eats up the cocaine in the blood like a little Pac-man before it can reach the brain. We believe this strategy is a win-win for those individuals, among the estimated 1.4 million cocaine users in the United States, who are committed to breaking their addiction to the drug. Even if a person who receives the anti-cocaine vaccine falls off the wagon, cocaine will have no effect," said lead researcher Dr. Ronald G. Crystal.
Meanwhile, cocaine may not be the most widely abused drug in America, but it is one of the most dangerous.
"Cocaine addiction may not be number one in the charts, but it's number one in terms of emergency room visits," Goldstein pointed out.
Indeed, cocaine was involved in nearly 423,000 emergency room visits in 2009 according to SAMHSA. That’s more than marijuana, heroin, and other stimulants and illicit drugs.
SOURCES: 1. JAMA Psychiatry, "Effects of Methylphenidate on Resting-State Functional Connectivity of the Mesocorticolimbic Dopamine Pathways in Cocaine Addiction", Anna B. Konova, MA, Scott J. Moeller, PhD, Dardo Tomasi, PhD, Nora D. Volkow, MD, Rita Z. Goldstein, PhD, published online June 26, 2013;():1-11. doi:10.1001/jamapsychiatry.2013.1129. 2. Neuropsychopharmacology, "Adenovirus Capsid-Based Anti-Cocaine Vaccine Prevents Cocaine from Binding to the Nonhuman Primate CNS Dopamine Transporter" (May 10, 2013) | doi:10.1038/npp.2013.114