Chronic cocaine use is associated with decreases in blood flow to the brain, but the mechanism for this decrease is not fully understood. Researchers theorize cocaine-induced constriction of the arteries in the brain and/or increased blood clotting may be involved.

The problems associated with decreased brain blood flow in some cocaine abusers are the results of major stokes such as paralysis, loss of ability to speak, severe cognitive impairment and in the worst cases death. The patients in these studies with reduced blood flow to their brain had significant impairment in thinking, concentrating, reading and remembering things. They also had significant depressive symptoms that may be related to these deficiencies in brain functioning due to lack of sufficient blood flow to the neurons. Thus, increasing blood flow back to normal can reverse these cognitive impairments and make these patients more responsive to our behavioral treatments which require learning of new skills to refuse drugs. These improvements in cognition can also enable these patients to return to productive employment and be active members of society.

To gauge the effects of the diuretic amiloride on cocaine dependent subjects, Thomas Kosten, M.D., professor of psychiatry at Yale School of Medicine, and colleagues administered amiloride, aspirin or placebo to 49 patients for one month while they resided on a research unit. Blood flow in the brain was measured on admission to the unit and at the end of treatment.

At the time they were enrolled in the study, cocaine-dependent subjects showed decreased cerebral blood flow compared to 18 control subjects. After four weeks of treatment the researchers found that the amiloride, but n
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Contact: Jacqueline Weaver, Yale University
203-432-8555
Elsevier
24-Aug-2003