Epilepsy Drug May Treat Cocaine Addiction

Yahoo News ^ | 9/22/03 | Steven Reinberg

[Libloather]

Epilepsy Drug May Treat Cocaine Addiction
1 hour, 26 minutes ago
By Steven Reinberg
HealthDay Reporter

MONDAY, Sept. 22 (HealthDayNews) -- Gamma-vinyl-GABA (GVG), a drug used to treat epilepsy, appears to help people end their addiction to cocaine, according to the results of the first human trial on heavy users.

"In a population of hardcore cocaine users, we were able to block their craving for the drug and keep them off cocaine for over 90 days," says researcher Dr. Stephen Dewey, a senior scientist with the Department of Energy's Brookhaven National Laboratory in Upton, N.Y.

"We were able to do this despite their living in their communities where all the cues and all the environmental triggers that cause relapse are at work," he adds.

"This drug offers a treatment that seems to work for an extended period, and offers the possibility of breaking a cycle of addiction and relapse," says co-researcher Dr. Jonathan Brodie, a professor of psychiatry at New York University School of Medicine.

The research team treated 19 men and one woman who had been cocaine addicts for three to 15 years. During the first week of the trial, which took place in the Mexican state of Baja California, the subjects received doses of GVG up to three grams. Thereafter, the patients received maintenance doses of four grams.

During the trial, patients had to remain free of cocaine for 28 days. After that, the dose of GVG was reduced by one gram per week over three weeks, which completed the treatment.

Eight of the subjects dropped out of the trial during the 10 days because they did not want to stop using cocaine, according to the report in the Sept. 22 online edition of Synapse.

Of the remaining 12 subjects, eight completed the study and were taken off GVG. All of these subjects have remained cocaine-free for more than a month after stopping GVG. In addition, they report their desire for cocaine did not return after GVG therapy.

The four remaining patients, while not able to kick their cocaine habit, reduced the amount of cocaine they used by 50 percent to 80 percent, the researchers report.

"We are heading in a direction for the effective treatment for cocaine addiction," Dewey says.

Moreover, "we are headed toward a strategy that can be applied to all forms of addiction, whether it's cocaine, nicotine, heroin, alcohol or methamphetamines."

All addictive substances increase brain dopamine, which plays a role in feeling good, Dewey says. "When you take an addictive substance, the production of dopamine increases hundreds and hundreds above normal," he adds.

In animal experiments, Dewey's team has shown that GVG inhibits the dopamine response by blocking the excess production of dopamine.

This first human study of GVG for curbing cocaine addiction was done in Mexico because GVG is not approved for use in the United States. However, it is approved for treating epilepsy in some 60 countries, Dewey says. Dewey adds he is working to start clinical trials using GVG for addiction done in the United States.

"There is hope," Dewey says. "We are onto something that is going to have a profound impact on the treatment of all addiction."

Brodie cautions that in addition to GVG, patients need social and psychological support and continued follow-up. "The idea that just giving a pill and saying you're going to be cured is naive," he says.

GVG does, however, have a major drawback. In clinical trials during the 1990s in the United States, researchers found GVG constricted peripheral vision in a small group of patients with epilepsy. Based on this, the approval application for the GVG was no longer pursued.

Over the past 20 years, more than 250,000 children have been treated long-term with GVG, with about 30 percent to 40 percent reporting visual field changes, according to recent studies.

And the reports in the medical literature are contradictory as to whether these eyesight defects are reversible after treatment is stopped.

GVG is made by Aventis Pharmaceuticals and sold under the names Sarbril and Vigabatrin.

Dr. Thomas R. Kosten, a professor of psychiatry at Yale University, comments that "this study was not very impressive -- its effect did not look very big to me. Also, there was no control group."

"We have looked at other gamma agents that are safe and available in the U.S., and these have shown efficacy in control studies, and have a bigger effect than what was shown with GVG in this study," he adds. "I don't see exposing people to a medication that can make you blind for treating substance abuse. I think it's just a waste of time."

[annyokie]

What is this drug? I have had epilepsy since I was 18, follwing a head injury and do very well on phenobarbitol. It's cheap and it works.

Seizure free for 14 years.

[philetus]

The only thing that treats any addiction, is when the addict decides he/she truly wants to quit, no matter what.

[yankeedame]

Well, now we come to the question: Do these addicts really want to kick the habit?

It's like someone pointed out that most (not all, of course) drunks don't want get on the wagon. The truth of the matter is they like to drink, they like the buzz, the way it makes them feel. What they don't like is the hangover. Get rid of that and you're not going to have many drunks wanting to get clean and sober.

Same thing might be true of drug addicts. Do they (again, a majority not all) really want to get off of drugs or, like the drunk, do they really just want to get rid of the downside?

I personally don't know, but it is an interesting point to ponder.

[Nov3]

FOB?

[philetus]

No thanks, I have a wristwatch.

[FreePaul]

This drug will be banned from the market soon. There is no way we can have a successful way to reduce or stop drug use. Think of all of the jobs that will be lost if we stop chasing, arresting and incarceration of users.

[Monty22]

I've been on Keppra, and it seems to have helped my cravings for Ambien..

Must be some Gaba thing afterall.

[annyokie]

I hope you're not trying to be funny. Epilepsy is not a joking matter.

[Monty22]

Not at all, I have left temporal lobe epilepsy.

[annyokie]

Thanks! Mine is unspecific. I never heard of your meds.

[Monty22]

Keppra is brand new. It was either this one, or one that needs blood work a lot. So I picked this one.

I didn't know I had it until I was 29! I had a car wreck and the ignorant cop tossed me in jail on a DWI (which I'm still fighting, already cost me one job). Then I had another one, and that cop took me to the hospital. So I finally got treated.

[Sandy]

Pretty useless study without a control group.

[annyokie]

At least I never wrecked my car. I did freak out the folks at work, however, and lost my driver's license for a year.

Have you ever been on Phenobarbitol? It's cheap and it works great.

[Monty22]

No, only Keppra. Do you need blood tests?

[annyokie]

Yes, but they are annual. And it's just to make sure I'm not taking too much.

[Jennifer in Florida]

I've never heard of this one either.. but I just looked it up, it is also called Vigabatrin or Sabril and is used as an add-on for partial seizures. It must be a new med. I've been on various antiseizure meds since '97 - taking Trileptal now.

[annyokie]

Is it working well for you? I took Dilantin for some time, then the dental issue(see above) came up and went back to phenobarb. It costs me $10 a prescription (30 days worth.)

I took a few others along the way, but the names escape me. Depakote was one. It made me very sleepy.

[Jennifer in Florida]

I was also on Dilantin, for about 4 1/2 years. Dilantin worked pretty well but there were a lot of side effects and my neuro wanted to switch it. I took Topamax, Carbatrol and now Trileptal after stopping Dilantin. Carbatrol and Trileptal are basically the same drug (a form of Tegretol) but they have improved over time. I switched to Trileptal because I don't need blood work with it. It is working fine, I had some stomach problems during the first month or so but no problems now. :)

[annyokie]

I'm glad they are working for you. I only need annual bloodwork so that's not a big deal.

Dilantin had too many side affects for me. I got a lot of headaches, for instance.