Pharmacological approaches to cocaine addiction.

The involvement of central dopamine (DA) neurons in the rewarding action of cocaine is well established. Cocaine euphoria depends on DA activation, and cocaine increases DA neurotransmission by blocking synaptic reuptake. Chronic cocaine use, however, appears to deplete brain DA, and perhaps leads to cocaine craving and withdrawal states. Bromocriptine, a specific DA receptor agonist, appears to ameliorate cocaine craving. Possible clinical roles for bromocriptine, and for DA receptor antagonists, are outlined.