NIMODIPINE PHARMACOTHERAPEUTIC ADJUVANT THERAPY FOR INPATIENT TREATMENT OF COCAINE DEPENDENCE

Recent preclinical studies suggest utility for voltage-sensitive calci um channel blockers (VSCCBs) in the treatment of cocaine addiction. Th e following double-blind placebo-controlled study examined the role of the VSCCB nimodipine in attenuating cocaine craving in 66 recently ab stinent cocaine-dependent patients on an inpatient substance abuse tre atment unit utilizing an intensive 12-step milieu-oriented psychosocia l therapy. While the medication was well tolerated, the dose of nimodi pine used in this study (90 mg q.d.) was not superior to placebo in re ducing background or cue-induced cocaine craving over the 3 weeks of t he study. There was the suggestion that nimodipine might attenuate the severity of some cocaine-induced brain deficits, as detected by evalu ation of smooth pursuit eye movement function. A rationale for evaluat ing higher doses of nimodipine for the treatment of cocaine addiction is presented. As nimodipine might have anticraving and mood-stabilizin g properties and cardio- and neuroprotective properties in the face of cocaine intoxication and might possibly even reverse some cocaine-ind uced brain deficits, further investigation of the role of nimodipine ( and other VSCCBs) in cocaine addiction appears an attractive avenue of future medication development.