Agonist-like pharmacotherapy for stimulant dependence: Preclinical, human laboratory, and clinical studies

David V. Herin, Craig R. Rush, John Grabowski

Research output: Chapter in Book/Report/Conference proceedingChapter

78 Scopus citations

Abstract

A variety of natural and synthetic agents have long been used for stimulant properties, with nontherapeutic use producing multiple waves of stimulant abuse and dependence. The multitude of effects of stimulants exist on continua, and accordingly, here we characterize stimulant abusedependence and candidate pharmacotherapies in this manner. Behavioral therapy and medications have been investigated for treatment of stimulant abusedependence. Effectiveness of some behavioral interventions has been demonstrated. Most medications studied have been found to lack efficacy. However, an expanding literature supports use of agonist-like medications to treat stimulant abusedependence, a strategy effective for nicotine and opiate dependence. The agonist-like conceptualization for stimulant dependence posits that medications with properties similar to that of the abused drug, but possessing lesser abuse liability, will normalize neurochemistry and stabilize behavior, thus reducing drug use. Data suggest use of a range of medications, from l-dopacarbidopa to amphetamine preparations, depending on the severity of use. This report reviews preclinical, human laboratory, and clinical trial data supporting the agonist-like approach, including risks and benefits. Future directions for development of agonist-like medications are also discussed.

Original languageEnglish (US)
Title of host publicationAddiction Reviews 2
PublisherBlackwell Publishing Inc
Pages76-100
Number of pages25
ISBN (Print)9781573317672
DOIs
StatePublished - Feb 2010

Publication series

NameAnnals of the New York Academy of Sciences
Volume1187
ISSN (Print)0077-8923
ISSN (Electronic)1749-6632

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Keywords

  • Agonist
  • Amphetamine
  • Bupropion
  • Cocaine
  • Medication development
  • Methamphetamine
  • Modafinil
  • Stimulant abuse
  • Substitution
  • Treatment

Cite this

Herin, D. V., Rush, C. R., & Grabowski, J. (2010). Agonist-like pharmacotherapy for stimulant dependence: Preclinical, human laboratory, and clinical studies. In Addiction Reviews 2 (pp. 76-100). (Annals of the New York Academy of Sciences; Vol. 1187). Blackwell Publishing Inc. https://doi.org/10.1111/j.1749-6632.2009.05145.x