Pharmacothérapies actuelles et immunothérapie dans l’addiction à la cocaïne

La cocaïne est une drogue de plus en plus consommée en France. La dépendance à ce produit est à l’origine de nombreuses complications somatiques, psychiatriques et sociales. Aucune pharmacothérapie n’est actuellement validée pour traiter ce trouble (syndrome de sevrage, prévention de rechute). Les a...

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Published inLa Presse médicale (1983) Vol. 37; no. 4; pp. 689 - 698
Main Authors Karila, Laurent, Weinstein, Aviv, Benyamina, Amine, Coscas, Sarah, Leroy, Claire, Noble, Florence, Lowenstein, William, Aubin, Henri-Jean, Lépine, Jean-Pierre, Reynaud, Michel
Format Journal Article
LanguageFrench
Published Paris Elsevier Masson SAS 01.04.2008
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Abstract La cocaïne est une drogue de plus en plus consommée en France. La dépendance à ce produit est à l’origine de nombreuses complications somatiques, psychiatriques et sociales. Aucune pharmacothérapie n’est actuellement validée pour traiter ce trouble (syndrome de sevrage, prévention de rechute). Les avancées majeures en neurobiologie, en imagerie cérébrale fonctionnelle et les résultats de certains essais cliniques suggèrent que des molécules agissant sur les systèmes GABAergique, dopaminergique et glutamatergique ainsi que l’immunothérapie pourraient améliorer certains aspects cliniques de la dépendance à la cocaïne. Différents traitements comme le modafinil, les agents GABAergiques (baclofène, topiramate, tiagabine, vigabatrine), le disulfiram, l’aripiprazole, la N-acétylcystéine et le vaccin anticocaïne semblent donner des résultats prometteurs. Cependant, il est nécessaire de les confirmer sur des échantillons de patients plus larges. Cocaine is more and more used and abused in France. Cocaine dependence is quite serious and is associated with numerous adverse health consequences. No effective pharmacotherapy for cocaine dependence is yet available. Recent advances in neurobiology, brain imaging and some clinical trials suggest that certain medications that modulate GABAergic, dopaminergic, and glutamatergic systems, as well as immunotherapy, show promise in the treatment of cocaine addiction. Recent controlled clinical studies have tested some of these drugs, which act on the various neurobiological circuits modified by cocaine exposure and clinically improve patients’ symptoms. Pharmacological agents such as modafinil, GABAergic agents (baclofen, topiramate, tiagabin, and vigabatrin), disulfiram, aripiprazole, N-acetylcysteine and cocaine vaccine seem very promising in the treatment of cocaine dependence. However, this must be confirmed in larger patient populations.
AbstractList La cocaïne est une drogue de plus en plus consommée en France. La dépendance à ce produit est à l’origine de nombreuses complications somatiques, psychiatriques et sociales. Aucune pharmacothérapie n’est actuellement validée pour traiter ce trouble (syndrome de sevrage, prévention de rechute). Les avancées majeures en neurobiologie, en imagerie cérébrale fonctionnelle et les résultats de certains essais cliniques suggèrent que des molécules agissant sur les systèmes GABAergique, dopaminergique et glutamatergique ainsi que l’immunothérapie pourraient améliorer certains aspects cliniques de la dépendance à la cocaïne. Différents traitements comme le modafinil, les agents GABAergiques (baclofène, topiramate, tiagabine, vigabatrine), le disulfiram, l’aripiprazole, la N-acétylcystéine et le vaccin anticocaïne semblent donner des résultats prometteurs. Cependant, il est nécessaire de les confirmer sur des échantillons de patients plus larges. Cocaine is more and more used and abused in France. Cocaine dependence is quite serious and is associated with numerous adverse health consequences. No effective pharmacotherapy for cocaine dependence is yet available. Recent advances in neurobiology, brain imaging and some clinical trials suggest that certain medications that modulate GABAergic, dopaminergic, and glutamatergic systems, as well as immunotherapy, show promise in the treatment of cocaine addiction. Recent controlled clinical studies have tested some of these drugs, which act on the various neurobiological circuits modified by cocaine exposure and clinically improve patients’ symptoms. Pharmacological agents such as modafinil, GABAergic agents (baclofen, topiramate, tiagabin, and vigabatrin), disulfiram, aripiprazole, N-acetylcysteine and cocaine vaccine seem very promising in the treatment of cocaine dependence. However, this must be confirmed in larger patient populations.
Author Reynaud, Michel
Aubin, Henri-Jean
Weinstein, Aviv
Karila, Laurent
Lépine, Jean-Pierre
Leroy, Claire
Noble, Florence
Lowenstein, William
Benyamina, Amine
Coscas, Sarah
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Issue 4
Keywords Traitement
Cocaïne
Addiction
Homme
Chimiothérapie
Immunothérapie
Toxicomanie
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Snippet La cocaïne est une drogue de plus en plus consommée en France. La dépendance à ce produit est à l’origine de nombreuses complications somatiques,...
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SubjectTerms Conduites addictives
Etude clinique de l'adulte et de l'adolescent
Generalites
Psychologie. Psychanalyse. Psychiatrie
Psychopathologie. Psychiatrie
Sciences biologiques et medicales
Sciences medicales
Toxicomanie
Title Pharmacothérapies actuelles et immunothérapie dans l’addiction à la cocaïne
URI https://dx.doi.org/10.1016/j.lpm.2007.08.015
Volume 37
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