Cocaine craving may be reduced by epilepsy drug

By David Douglas

NEW YORK (Reuters Health) - Short-term treatment with the anticonvulsant drug, vigabatrin (gamma vinyl-GABA), appears to be effective in reducing the need for cocaine and methamphetamine in addicts. And the drug produced no signs of visual field loss, researchers report in the Archives of Ophthalmology.

"Vigabatrin is a medication with a long history of use for complex seizure disorders," lead investigator Dr. Robert D. Fechtner told Reuters Health, "but with a well-known side effect of irreversible vision loss with chronic treatment."

"Preliminary data have shown that vigabatrin can be effective in blocking the craving and effects of methamphetamine and cocaine, but we did not know if we would see vision loss with short-term use in drug abusers," he added.

To investigate, Dr. Fechtner of the University of Medicine and Dentistry of New Jersey, Newark and colleagues studied 30 subjects who were abusing cocaine, methamphetamine or both drugs.

In this 9-week safety study, participants were given escalating daily doses of vigabatrin for 6 weeks and were tapered off during the remaining 3 weeks.

In total, 18 of the subjects completed the study and 16 tested negative for methamphetamine and cocaine in the last 6 weeks of the trial.

Repeated monitoring showed that the vigabatrin did not produce any visual field defects or alterations in visual acuity. Furthermore, the drug did not produce changes in vital signs even if the patient continued to use methamphetamine and cocaine.

"Our study found no evidence of vision loss when vigabatrin was used for the treatment of methamphetamine and cocaine abuse," Fechtner continued.

"While the results are preliminary and must be confirmed in larger studies," he concluded, "it is very encouraging to see that there may be a safe and effective treatment for this devastating addiction."

SOURCE: Archives of Ophthalmology, September 2006.