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Fortschr Neurol Psychiatr
DOI: 10.1055/a-2537-9595
Originalarbeit

Flimsy but handy: Devising an algorithm as a novel approach to the pharmacotherapy of cocaine addiction

Auf tönernen Füßen: Entwicklung eines Algorithmus als neuen Ansatz für die Pharmakotherapie der Kokainabhängigkeit
Sebastian Karl Maximilian Fischer
1   Psychiatric Services Lucerne, Lucerne, Switzerland
2   Institute of General Practice and Family Medicine, Ludwig Maximilian University of Munich, Munich, Germany (Ringgold ID: RIN9183)
,
Jochen Mutschler
1   Psychiatric Services Lucerne, Lucerne, Switzerland
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Abstract

Cocaine addiction is a devastating disorder, not only for the individual but also for society. Due to the rapid increase in cocaine consumption worldwide, cocaine and its deleterious psychiatric and physical consequences have increasingly become a major focus of addiction medicine. Unfortunately, advances in the treatment of cocaine addiction cannot keep pace with the surging demand for effective, fast-acting, readily available and affordable therapies. Psychosocial and psychotherapeutic measures are still the mainstay of therapy, but many patients do not have access to or benefit sufficiently from these treatment modalities. To date, there is no pharmacotherapy that has been approved or shown to be consistently effective for cocaine addiction. Nonetheless, a fair number of promising candidate substances can be extracted from a large pool of studies and there exists enough evidence to justify the assumption that many patients are likely to benefit from at least one of these substances. We have thoroughly analyzed the literature and contributed our own research results in order to integrate clinically relevant findings into an algorithm that enables the clinician to make the current state of knowledge usable in routine practice.

Zusammenfassung

Kokainabhängigkeit ist eine verheerende Erkrankung, nicht nur für den Einzelnen, sondern auch für die Gesellschaft. Aufgrund des rapiden Anstiegs des weltweiten Kokainkonsums sind Kokain und dessen schädliche psychiatrische und körperliche Folgen zunehmend in den Mittelpunkt der Suchtmedizin gerückt. Leider können die Fortschritte bei der Behandlung der Kokainabhängigkeit nicht mit der steigenden Nachfrage nach wirksamen, schnell wirkenden, leicht verfügbaren und erschwinglichen Therapien Schritt halten. Psychosoziale und psychotherapeutische Maßnahmen sind nach wie vor der Eckpfeiler der Therapie, aber viele Patienten haben keinen Zugang oder profitieren nicht ausreichend davon. Bislang gibt es keine zugelassene oder in Studien konsistent wirksame Pharmakotherapie für die Kokainabhängigkeit. Dennoch lassen sich aus einer Vielzahl von Studien einige vielversprechende Kandidatensubstanzen herausfiltern, und es gibt genügend Belege, welche die Annahme rechtfertigen, dass viele Patienten wahrscheinlich von mindestens einer dieser Substanzen profitieren. Die vorliegende Untersuchung basiert auf einer umfassenden Auswertung der relevanten Literatur sowie der Integration eigener Forschungsergebnisse in einen Algorithmus. Dieser ermöglicht dem Kliniker, den aktuellen Wissensstand für die Routinepraxis nutzbar zu machen.

Keywords

cocaine addiction - cocaine use disorder - pharmacotherapy - algorithm - ADHD

Schlüsselwörter

Kokainabhängigkeit - Pharmakotherapie - Algorithmus - ADHS


Publikationsverlauf

Eingereicht: 21. Oktober 2024

Angenommen nach Revision: 31. Januar 2025

Artikel online veröffentlicht:
11. März 2025

© 2025. Thieme. All rights reserved.

Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

 

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