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RESULTS FROM FIRST CLINICAL TRIAL USING GVG TO TREAT ADDICTION
16 May 2007 - DOE/Brookhaven National Laboratory

Using an experimental addiction treatment first investigated at the U.S. Department of Energy’s Brookhaven National Laboratory, a team of scientists from Brookhaven, the New York University School of Medicine, and a national addiction treatment center in Mexico report prolonged abstinence and the elimination of drug craving in eight out of 20 hard-core, long-term cocaine addicts who enrolled in the study. This is the first human clinical data showing that gamma vinyl-GABA (GVG, vigabatrin) holds promise as a pharmacological treatment for cocaine addiction.

“It is extremely gratifying to see these early human results bear out what we’ve observed in our extensive preclinical animal studies with GVG,” said Brookhaven neuroanatomist Stephen Dewey, who has been using animal models and brain imaging techniques to investigate GVG’s effects on neurochemistry and addictive behavior for more than ten years. These animal experiments have shown that GVG can block drug-induced increases in brain dopamine (a chemical associated with reward and pleasure, which is elevated by all addictive drugs), drug-seeking behavior, drug self-administration and sensitization, and drug craving, even that triggered by environmental cues.

“This promising work on a potential treatment for drug addiction illustrates the value of the Department of Energy’s basic research in physics, chemistry, and imaging sciences,” said Secretary of Energy Spencer Abraham. “The advanced technologies developed in the DOE laboratories are being applied to a number of critical national health issues, including the problem of drug abuse.”

Said lead author Jonathan Brodie, a psychiatrist and biochemist at NYU who also collaborated on the animal experiments, “These human clinical data support the need for a larger double-blind placebo-controlled trial that will more carefully examine the risk/benefit relationship for GVG in the treatment of cocaine addiction, a life-threatening disease for which there are currently no effective pharmacological treatments.”

Twenty daily cocaine abusers who expressed an interest in breaking their drug dependence were enrolled and given an escalating daily dose of GVG, starting with one gram twice a day, and reaching two grams twice a day by day seven of the trial. The subjects were treated as outpatients, allowed to return home each day and go about their normal lives. They were encouraged to participate in group and individual therapy programs, and all were required to provide urine samples for drug screening twice weekly and complete daily questionnaires on drug use and craving.

Eight subjects dropped out within the first 10 days, stating that they did not wish to stop their cocaine use. Of the 12 who continued treatment with GVG, eight achieved periods of abstinence of more than 28 consecutive days, the duration set as a benchmark for successful treatment. All eight were tapered off GVG after completion of the trial, and remained drug-free at the time of publication. Four other patients stayed in the trial for periods ranging from 25 to 43 days but continued to use cocaine, albeit in significantly reduced amounts. None of the study participants reported any visual disturbances.

Those who completed the study reported that their craving for cocaine was eliminated within two to three weeks. They showed profound behavioral gains in self-esteem, family relationships, and work activities.

“The success rate achieved in this small study, 8 out of 20 remaining in the trial and drug-free, is comparable to that of other experimental cocaine addiction treatment protocols. But the prolonged duration of abstinence far exceeds what other pharmacological treatments have achieved,” said Dr. Frank Vocci, Director, Division of Treatment Research and Development, National Institute on Drug Abuse.

“The results are particularly impressive considering that the study subjects remained in the same neighborhood, where the drug is readily available, and with all the cues and social pressures that supported their addiction for so many years,” said Figueroa.

The scientists hope that larger scale trials on GVG will be conducted at NIDA-sponsored addiction research centers in the U.S. to investigate its efficacy as a treatment for addiction as well as any side effects.

http://www.bnl.gov

About: DOE/Brookhaven National Laboratory
Established in 1947 on Long Island, Upton, New York, Brookhaven is a multi-program national laboratory operated by Brookhaven Science Associates for the US Department of Energy (DOE). Six Nobel Prizes have been awarded for discoveries made at the Lab.

Brookhaven has a staff of approximately 3,000 scientists, engineers, technicians and support staff and over 4,000 guest researchers annually.

Brookhaven National Laboratory's role for the DOE is to produce excellent science and advanced technology with the cooperation, support, and appropriate involvement of our scientific and local communities. The fundamental elements of the Laboratory's role in support of the four DOE strategic missions are the following:

To conceive, design, construct, and operate complex, leading edge, user-oriented facilities in response to the needs of the DOE and the international community of users.

To carry out basic and applied research in long-term, high-risk programs at the frontier of science.

To develop advanced technologies that address national needs and to transfer them to other organizations and to the commercial sector.

To disseminate technical knowledge, to educate new generations of scientists and engineers, to maintain technical capabilities in the nation's workforce, and to encourage scientific awareness in the general public.


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