Effects of short-term citicoline treatment on acute cocaine intoxication and cardiovascular effects

Rationale: The majority of pharmacotherapies proposed for cocaine dependenc e have been marginally effective and frequently have undesirable side effec ts. We recently demonstrated that short-term treatment with citicoline decr eased self-reported desire to use cocaine in crack cocaine users. Objective : The present study was conducted to assess the safety of citicoline in com bination with cocaine by investigating whether cocaine-induced cardiovascul ar and behavioral effects and cocaine plasma levels are altered by citicoli ne pretreatment. Methods: Eight healthy male and female volunteers who used cocaine on an occasional basis participated in this randomized, placebo-co ntrolled, three-visit study. During all three visits, subjects received an acute intranasal dose of cocaine (0.9 mg/kg) and were continuously monitore d for the ensuing 3.5 h. The first visit involved no pretreatment, and visi ts 2 and 3 were preceded by a 4-day pretreatment period of either citicolin e (1 g/day) or placebo. Results: Citicoline pretreatment did not alter the cardiovascular, physiologic, or subjective effects of acute cocaine. Conclu sions: Although citicoline did not block the acute subjective effects of co caine in a laboratory environment, the combined use of citicoline and a mod erate dose of intranasal cocaine presented no added risk of cardiovascular effects. Further study is necessary to determine whether this medication (w hich is currently used to treat strokes) will be a useful adjunct to treat cocaine dependence.