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A new grant from the NIH National Institute on Drug Abuse (NIDA) will give CNRA researchers, Drs. Schmitz and Lane, the funding support they need to pursue a line of research evaluating neuroprotective medications in combination with behavioral therapy for the treatment of cocaine use disorder. 

The research team will conduct a double-blind, placebo controlled randomized clinical trial of a medication called pioglitazone.  Pioglitazone is a PPAR-gamma agonist that is FDA-approved for the treatment of Type 2 diabetes.  Its mechanism of action is complex, but includes anti-neuroinflammatory effects, making pioglitazone an intriguing and promising medication for neurological conditions such as Parkinson’s disease, Alzheimer’s disease, brain trauma and stroke. Similar to these brain afflictions, studies of cocaine addiction conducted at the CNRA and elsewhere have shown that chronic cocaine use can have widespread neurotoxic effects, including in areas of the brain associated with cognitive function.  Clinically, it has been shown that the degree of cocaine-induced brain structure and function negatively predicts successful outcome following treatment, that is, more impairment results in worse outcomes.

Leading up to this grant, Lane and Schmitz conducted the first human neuroimaging study to demonstrate how pioglitazone treatment can change brain white matter integrity in patients with cocaine use disorder.  Their published findings showed that pioglitazone produced significant improvement in white matter integrity compared to placebo. Additionally, patients who received pioglitazone showed reduced craving for cocaine. Armed with encouraging findings, Schmitz and Lane are now ready to test pioglitazone as a potential “relapse prevention” medication in recently detoxified patients with cocaine use disorder.

“Our thinking” says Schmitz, “is that adjunctive treatment with pioglitazone will facilitate the recovery process in these individuals by improving neural and cognitive functioning, so that patients might benefit more from evidence-based behavioral therapies for cocaine use disorder. We know that a healthier brain benefits more from therapy efforts than one that is substantially disrupted.”

The trial has begun enrolling participants.  For more information, please call 713-500-DRUG (3784) or visit: cnraclinic.com/2step