A single dose of a commonly-prescribed attention deficit
hyperactivity disorder (ADHD) drug helps improve brain function in cocaine
addiction, according to an imaging study conducted by researchers from the
Icahn School of Medicine at Mount Sinai. Methylphenidate (brand name Ritalin®)
modified connectivity in certain brain circuits that underlie self-control and
craving among cocaine-addicted individuals. The research is published in JAMA Psychiatry, a JAMA network
Previous research has shown that oral methylphenidate
improved brain function in cocaine users performing specific cognitive tasks
such as ignoring emotionally distracting words and resolving a cognitive
conflict. Similar to cocaine, methylphenidate increases dopamine (and
norepinephrine) activity in the brain, but, administered orally, takes longer
to reach peak effect, consistent with a lower potential for abuse.
How it works
By extending dopamine's action, the drug enhances signalling
to improve several cognitive functions, including information processing and
"Orally administered methylphenidate increases dopamine
in the brain, similar to cocaine, but without the strong addictive
properties," said Rita Goldstein, PhD, Professor of Psychiatry at Mount
Sinai, who led the research while at Brookhaven National Laboratory (BNL) in
"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."
Anna Konova, a doctoral candidate at Stony Brook University,
who was first author on this manuscript, added, "Using fMRI, we found that
methylphenidate did indeed have a beneficial impact on the connectivity between
several brain centres associated with addiction."
Dr Goldstein and her team recruited 18 cocaine addicted
individuals, who were randomized to receive an oral dose of methylphenidate or
placebo. The researchers used functional magnetic resonance imaging (fMRI) to
measure the strength of connectivity in particular brain circuits known to play
a role in addiction before and during peak drug effects. They also assessed
each subject's severity of addiction to see if this had any bearing on the
Methylphenidate decreased connectivity between areas of the
brain that have been strongly implicated in the formation of habits, including
compulsive drug seeking and craving. The scans also showed that methylphenidate
strengthened connectivity between several brain regions involved in regulating
emotions and exerting control over behaviours—connections previously reported
to be disrupted in cocaine addiction.
"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,"
said Dr. Goldstein. "This is a preliminary study, but the findings are
exciting and warrant further exploration, particularly in conjunction with
cognitive behavioural therapy or cognitive remediation."