The HPA axis in cocaine use: Implications for pharmacotherapy

The role of the hypothalamic-pituitary-adrenal (HPA) axis in cocaine use is reviewed within the context of two approaches to developing pharmacologica l treatments in humans: (1) reducing the reinforcing effects of cocaine and (2) reducing cocaine addict's susceptibility to stress-induced relapse. Th is review suggests that HPA-axis-suppressing medications are unlikely to bl ock cocaine's reinforcing effects completely but may be useful in decreasin g the frequency of use by increasing the addicted individual's resistance t o stress-induced relapse. Implications for designing inpatient studies to t est the safety and efficacy of candidate pharmacological agents are discuss ed. (C) 2001 by The Haworth Press, Inc. All rights reserved.