A single dose of Ritalin (methylphenidate) may help improve brain function in people addicted to cocaine, an imaging study carried out by scientists from the Icahn School of Medicine at Mount Sinai showed. The study has been published in JAMA Psychiatry.

Ritalin was found to modify connectivity in some of the brain circuits associated with craving and self-control among individuals addicted to cocaine.

Previous studies had demonstrated how oral methylphenidate could help cocaine users in resolving a cognitive conflict or ignoring emotionally distracting words.

Methylphenidate raises dopamine and norepinephrine activity in the brain, so does cocaine. However, as Ritalin is taken orally, it takes longer to reach peak effect, which reduces the risk of abuse. Ritalin extends dopamine's action, and thus improves signaling which leads to better cognitive functions, including attention and information processing.

Study leader, Rita Goldstein, PhD, Professor of Psychiatry at Mount Sinai, said:

"Orally administered methylphenidate increases dopamine in the brain, similar to cocaine, but without the strong addictive properties. We wanted to determine whether such substitutive properties, which are helpful in other replacement therapies such as using nicotine gum instead of smoking cigarettes or methadone instead of heroin, would play a role in enhancing brain connectivity between regions of potential importance for intervention in cocaine addiction."

First author, Anna Konova, added "Using fMRI, we found that methylphenidate did indeed have a beneficial impact on the connectivity between several brain centers associated with addiction."

The study included 18 individuals, all of them addicted to cocaine. They were randomly selected into two groups:
  • The oral dose of methylphenidate group
  • The oral dose of placebo group
Dr. Goldstein and colleagues used fMRI (functional magnetic resonance imaging) to see how strong the connections were in parts of the brain known to be associated with addiction.

Imaging scans were carried out before and during the peak drug effects. They also assessed each participant to determine their addiction severity - the aim being to see whether this might have a bearing on the results.

The fMRI scans also showed that methylphenidate improved connectivity between a number of areas of the brain that regulate emotions and self-control. These connections are disrupted in cocaine addiction.

Dr. Goldstein said "The benefits of methylphenidate were present after only one dose, indicating that this drug has significant potential as a treatment add-on for addiction to cocaine and possibly other stimulants. This is a preliminary study, but the findings are exciting and warrant further exploration, particularly in conjunction with cognitive behavioral therapy or cognitive remediation."

Dr. Goldstein led a previous a study at the U.S. Department of Energy's Brookhaven National Laboratory which showed that oral Ritalin improved impaired brain function and enhanced cognitive performance in individuals addicted to cocaine. The study was published in PNAS (Proceedings of the National Academy of Sciences), September 2010 issue.

Anti-cocaine vaccine may not be far off - scientists from Weill Cornell Medical College reported that a new anti-cocaine vaccine was successfully tested on primates. They believe that human clinical trials are not far off. The animal trial was published in the journal Neuropsychopharmacology (May 2013 issue).

Dr. Ronald G. Crystal, lead researcher said "The vaccine eats up the cocaine in the blood like a little Pac-man before it can reach the brain. We believe this strategy is a win-win for those individuals, among the estimated 1.4 million cocaine users in the United States, who are committed to breaking their addiction to the drug. Even if a person who receives the anti-cocaine vaccine falls off the wagon, cocaine will have no effect."

Written by Christian Nordqvist