The potential of dopamine agonists in drug addiction.

The use of dopamine agonists in alcohol, stimulant and nicotine dependence has been examined. The direct agonists, such as bromocriptine and pergolide, have not shown utility in alcohol or cocaine abuse and dependence in larger controlled trials. Indirect agents, such as selegiline, may be helpful in cocaine or nicotine abuse and larger clinical trials are underway. Disulfiram may also raise dopamine levels and has shown promise for cocaine dependence. Other indirect agents, such as mazindol and methylphenidate, have not proven effective for cocaine addiction but have not been tested in alcohol or nicotine abuse. Agents for subtypes of dopamine receptors, such as D3, and the use of partial agonists may be useful future treatment approaches. Animal studies also suggest that tailoring treatment to subgroups of patients based on genotype may improve responses.