Abstract
This paper will examine how cerebral perfusion deficits in cocaine abusers may be a target for pharmacotherapy. The review covers five areas: (1) cerebral ischemia and neuropsychological impairment in cocaine abusers, (2) neuroimaging evidence for cerebral perfusion defects in cocaine abusers, (3) mechanisms for cocaine induced cerebral thrombosis, (4) neurotoxicity from cerebral ischemia and excitatory amino acids, (5) glutamate antagonists as potential treatment agents for cocaine induced neurotoxicity. Several pharmacotherapies are suggested including antiplatelet agents and excitatory amino acid (EAA) antagonists such as lamotrigine. Clinical trials in cocaine abusers with cerebral perfusion defects are indicated and EAA antagonists hold promise as they are developed for stroke treatment.
Publication types
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Research Support, U.S. Gov't, P.H.S.
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Review
MeSH terms
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Aspirin / therapeutic use
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Brain / blood supply
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Brain / diagnostic imaging
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Brain / drug effects
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Brain Ischemia / chemically induced
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Brain Ischemia / drug therapy*
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Brain Ischemia / physiopathology
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Cerebrovascular Circulation / drug effects
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Cocaine / adverse effects*
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Cocaine-Related Disorders / complications*
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Cocaine-Related Disorders / physiopathology
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Cognition Disorders / etiology*
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Excitatory Amino Acid Antagonists / therapeutic use
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Female
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Glutamic Acid / adverse effects
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Humans
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Intracranial Embolism and Thrombosis / chemically induced
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Intracranial Embolism and Thrombosis / drug therapy
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Male
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Nerve Degeneration / chemically induced
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Nerve Degeneration / physiopathology
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Neuropsychological Tests
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Platelet Aggregation Inhibitors / therapeutic use
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Radionuclide Imaging
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Substance Withdrawal Syndrome / physiopathology
Substances
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Excitatory Amino Acid Antagonists
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Platelet Aggregation Inhibitors
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Glutamic Acid
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Cocaine
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Aspirin