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Kicking Coke - Best Meds?

WarrenZevon

WarrenZevon

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Joined
Nov 19, 2007
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Thanks All,

I am looking for personal experiences here.
(I have read all the studies and lit. and tried various meds)

Simply, I must have grown countless DAT (dopamine reuptake transporters) and am totally coke dependent.

As anyone who has tried to quit knows - 3 days of hypersomnia, depression and boredom can feel like 3 weeks!

I know my brain needs to be clean for close to one month before one begins to function 'normally' again - but I think my record is 3 days.

If you have reports of meds that got you through those first weeks of hell - please share your story?

Thanks!
wz


PS - for what it is worth I have tried Welbutrin, Phenteramine, Tyrosine, NA Cystine and others. Bottom line - dopaminergic activity in my brain is out for the count...(I dream of carefully tapered Amineptine. God knows - I find tapering coke almost impossible. What about covering my body with Nicotine patches every day?!
 
Basically you want a long acting, high affinity, but not very active DAT inhibitor that only has a fraction of the activity of cocaine for increasing synaptic dopamine, but has such a high affinity that no amount of cocaine will displace it (ie. similar to the properties methadone or buprenorphine has at the mu receptor).

If pushed, I'd have said that pipradrol (note not desoxypipradrol, although it might be of some use) might have been a good bet, but it's as rare as hen's teeth in clinical use these days. Then again, if you have that bad a coke habit you'd probably end up being tempted to abuse whatever you were using to reduce the cocaine cravings. You could also always consider ibogaine - apparently Dr Deborah Mash has had good results using ibogaine therapy for cocaine addiction in conjunction with the uni of Miami (try googling her name & ibogaine for more details)
 
I realize....

that my contribution here to this question is just a lame-o web search, cause what you are looking for are tried and true methods from coke addicts who managed to kick the habit, but take them for what they are worth, At least i mean well.
http://www.musc.edu/pr/cocaine.htm
http://www.nida.nih.gov/NIDA_Notes/NNVol12N3/Compounds.html
http://www.nida.nih.gov/NIDA_Notes/NNVol10N5/CocaineTarget.htm
http://www.emedicinehealth.com/cocaine_abuse/page6_em.htm
http://www.addictionstudies.org/science_update-cocaine.html
http://www.hhs.gov/news/press/1996pres/960314h.html
http://www.jwoodphd.com/Addictions/cocaine.htm
http://www.hazelden.org/web/go/cocainehttp://jpet.aspetjournals.org/cgi/content/full/291/1/265
http://jpet.aspetjournals.org/cgi/content/full/291/1/265. What can be gleaned from this search is that GABA 2 agonists, and certain selective D1or D2 agonist would be efficacious. The other compounds mentioned (except baclofen, and N-acetyl cysteine) would be hard to get hold of. I'm not sure if anything really effective for counteracting cocaine withdrawal is on the market as of now, I'm sure the gurus can do better than me on this one.
 
GBR12909 would be the gold standard, but alas, it is not available as a clinical drug (in got stuck in Phase II, I think). There has been quite a lot of progress with various benztropine derivatives (eg 4,4-difluoro-benztropine), but again, availability is non-existent right now. Modafinil is a decent option, especially combined with an SNRI antidepressant (venlafaxine). Bupropion and modafinil combined might also be worth investigating. You could also try the D3 agonist pramipexole.

Even XR d-amphetamine can be an option (taken orally--as directed, at a low dose). Stay away from methylphenidate, it is too similar to coke in mechanism of action--you may be too tempted to resort to nasal administration.
 
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Direct dopamine agonists wouldn't be good, Bondmaker, especially with the raised extracellular concentrations of dopamine.

I see (or smell) a pukefest coming on, direct dopaminergic agonists cause vomiting by stimulating the chemoreceptor trigger zone.

Its how apomorphine works, its a compound made from morphine, with activity as an agonist at dopamine receptors (can't remember which ones offhand), and its been in use for a long time as a potent and rapid acting emetic.
 
Overwhelming Thanks! Please Keep Posting?

First - I am overwhelmed by all of your support and knowledge. My only regret is not having the time to reply to every poster here as they deserve. Thank You!

fastandbulbous said:
Basically you want a long acting, high affinity, but not very active DAT inhibitor that only has a fraction of the activity of cocaine for increasing synaptic dopamine, but has such a high affinity that no amount of cocaine will displace it (ie. similar to the properties methadone or buprenorphine has at the mu receptor).
Click to expand...

This would be the holy grail!

One 'creative' idea I had was finding an old, antipsychotic that blocks virtually all dopaminergic activity - to be taken only at bedtime. Kinda like a half assed Naltrexone induced 'detox'. Hypothetically - 'encouraging' downregulation of dopamine reuptake receptors

fastandbulbous said:
You could also always consider ibogaine - apparently Dr Deborah Mash has had good results using ibogaine therapy for cocaine addiction in conjunction with the uni of Miami (try googling her name & ibogaine for more details)
Click to expand...

I would be open to this as - when a market for real LSD existed - low doses were profoundly meaningful. Ibogaine however seems violently toxic.

IcarusRisen said:
I've heard that Modafinil is really good for reducing cocaine cravings.
Click to expand...

I have had little to no benefit from generic Modafinil (sun-pharma). Yet some have reported to me that the US brand name is infinitely better.

Gahan said:
Deprenyl is worth a shot
Click to expand...

I must agree. Sadly I am on so many other psychotropics that dosing gets very tricky.

I would risk Deprenyl via transdermal patch - but like Branded Provigil - the price is astronomical. No overseas generic D-Transdermals...

Riemann Zeta said:
You could also try the D3 agonist pramipexole.
Click to expand...

Very novel idea that I have considered. I find the substantial drowsiness reported to be discouraging.

Riemann Zeta said:
Even XR d-amphetamine can be an option (taken orally--as directed, at a low dose).
Click to expand...

Yes, studies on Adderal XR look very promising but it is impossible to obtain. Once 'diagnosed' with ADD - I had ample opportunity to try various stimulants (excepting Adderall) - they never 'did' anything for me until coke. (Actually tried both oral and intra-nasal methylphenidate. Oddly - this was my least impressive experience.)
I have had virtually no problems tapering from psychostimulants (other than coke). Though I have easy access to Phentermine - I develop very rapid (3 day) tolerance to its 'wakefulness' properties.

Bondmaker said:
that my contribution here to this question is just a lame-o web search, cause what you are looking for are tried and true methods from coke addicts who managed to kick the habit, but take them for what they are worth, At least i mean well.......Amantadine?
Click to expand...

Hey - I appreciate all your efforts! Many years ago - before messing with my brain - I was actually prescribed Amantadine for the Flu! The side effects were unspeakably bad for me. While I am confident that I can taper from any coke substitute - if we are hitting the exact same receptors - we seem to risk slowing down 'recovery'. Finally - recent studies show DRAMATIC long term changes in glutaminergic systems contributing to cocaine addiction.

Yes - I take high dose Welbutrin. It is a robust antidepressent when I am coke clean. But while abusing or during acute W/D - it does little to nothing for me.
I DO wonder - if combine with nicotine patches - if I would benefit? I am convinced that there is a profound glutaminergic contribution to coke addiction.

For this - several studies of N-acetyl cysteine look promising. (Did nothing for me). Studies showed that occasional, low dose ketamine was effective in reversing long term depression.

So - I am still grasping at straws. Unlike many - I simply have no access to rc's or several of the more promising possibilities above.

Besides adding nicotine patches or 'cycling' low dose Phentermine no more than every 2 days. I feel a bit lost.

THANK YOU ALL for your thoughts and experiences.
Thank you all so very much in advance to keep 'em coming.

Indebted,
WZ
 
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you could look into certain anti-parkinson drugs. to lazy to search for specifics, but, aside from the levodopa/combination pills the rest are basically dopamine receptor agonists. would that just make it worse or help temporarily? im not a pharmacologist so im not sure.
 
I'm afraid that with everything you've said you can't get, you really haven't left anything open.

benztropine? I doubt it'd be effect, but who knows.

Other drugs you haven't ruled out but have shown promise in clinical trials for this purpose:

Gabapentin
Vigabatrin
Topiramate
Tiagabine

not much else with everything else out of you willingness or ability.

Only other options are things like Dimethocaine and b-CFT... good luck getting those though.
 
modafinil or a low dose of dxm (35mg or so) every couple hours seems to do the trick for me
 
Hmmmm.........

What about Effexor? That's easy to get hold of. It would eliminate post stimulant depression and has weak to moderate action at DA and NE reuptake sites? Somebody has got to have tried this? It would be very interesting to know if it works as a "cocaine comedown alleviator". I'd make a bet that it could very well be the "buprenorphine" of cocaine addiction. It wouldn't be the total answer, because getting off effexor is no picnic either, but that's exactly my point, it would quell the cocaine urges long enough to get to the point where they were completely gone, then you spend some more time getting off the effexor. Anyway you look at it , it's going to be like getting off opiates completely, at least two weeks off work for to get straight again.
Just a thought. I could be pissing in the wind here.
Just found this
http://en.wikipedia.org/wiki/Cocaine_addiction#Venlafaxine
They say effexor had no DAT properties, but it's official abstract says it has low affinity for DA receptors.
 
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Actually, I've heard of quite a few cases where people have started using desoxypipradrol for recreational purposes only to find that their craving for cocaine is pretty much abolished. As desoxy does not seem to produce any noticable craving to redose, lasts for 24 hours from one dose and is much, much less toxic than cocaine (the diphenylpiperidines such as desoxy & pipradrol are noted for their physically benign nature), I'd say that it seems like an almost ideal 'methadone for coke addicts' as along with abolishing cravings, it has some psychomotor stimulant activity which prevents the lethargy etc associated with cocaine withdrawl. It got withdrawn after phase III trials by Ciba-Geigy in the early 60s because of it's long half life, which was a big negative for patients receiving it, but here it's a positive thing.

BTW, after dropping desoxypipradrol, Ciba-Geigy eventually went with methylphenidate as their psychomotor stimulant in pref to desoxy as it has a much shorter half life, making it better suited for purpose. Only thing is, when it comes to replacement/maintainance therapy for a drug of abuse, shorter half life generally equals higher abuse potential (think about the half lives of methadone & buprenorphine compared with most opiates), so methylphenidate is a non-starter as as 'methadone for coke addicts).

About time someone at a pharmaceutical firm dug out the trials of desoxypipradrol and looked at it again - I know self administration in a non-clinical setting is hardly a recommendation, but the incidences I've seen of coke seeking behaviour being effectively abolished by administration of low doses of desoxypipradrol (and some were long time coke users) surely make it something worth re-evaluating considering the current lack of a maintainance drug for cocaine dependant people
 
wasnt there just a study out of australia, looking at some stimulant to help methamphetamine addicts. that might help with cocaine

listen what you need to do is fill the void in your life that comes when you stop coke. you started using cocaine for a reason and if you find that and work on the motivations/influences that get you to use then you will be able to quit. alot of times people stop taking a drug- but everything in thier lives that got them to use is still there and they relapse in no time.
 
I was thinking that maybe a long acting ritalin might work--either concerta or the new ritalin patch (that starts with a d). It would probably be better then adderall, as I read a paper once that showed that ritalin had a similar effect on brain chemistry as cocaine but it was just slower, and don't cause the extreme euphoria. Therefore, methylphenidate might be a better option than amphetamines that have a completely different mechanism of action. Amphetamines have a very different effect from methylphenidate, and although they might replace your cravings for cocaine, they might start you on the path towards amphetamine dependence, which is just as bad.

Why are you thinking off adding nicotine patches? Are you trying to kick smoking too. Nicotine affects the nicotinic receptors, which respond to Ach. I don't recall cocaine having much affect on Ach. Basically, if you add nicotine patches all that is going to happen is that you are going to crave nicotine, which is one of the most addicting substances in the world. You are probably better with adding caffeine than nicotine, which will increase your dopamine levels, which is at least affecting the proper neurotransmitter and receptor.

Also, have you considered going to a rehab center? Albeit sucky, those things work for many people. If you really want to quit, and you just can't do it--sometimes you just need a bit of help. Taking you to a place where it is harder to get your drug of choice and having encouragement to keep you off may make all the difference.
 
fastandbulbous said:
Actually, I've heard of quite a few cases where people have started using desoxypipradrol for recreational purposes only to find that their craving for cocaine is pretty much abolished. As desoxy does not seem to produce any noticable craving to redose, lasts for 24 hours from one dose and is much, much less toxic than cocaine (the diphenylpiperidines such as desoxy & pipradrol are noted for their physically benign nature), I'd say that it seems like an almost ideal 'methadone for coke addicts' as along with abolishing cravings, it has some psychomotor stimulant activity which prevents the lethargy etc associated with cocaine withdrawl. It got withdrawn after phase III trials by Ciba-Geigy in the early 60s because of it's long half life, which was a big negative for patients receiving it, but here it's a positive thing.

BTW, after dropping desoxypipradrol, Ciba-Geigy eventually went with methylphenidate as their psychomotor stimulant in pref to desoxy as it has a much shorter half life, making it better suited for purpose. Only thing is, when it comes to replacement/maintainance therapy for a drug of abuse, shorter half life generally equals higher abuse potential (think about the half lives of methadone & buprenorphine compared with most opiates), so methylphenidate is a non-starter as as 'methadone for coke addicts).

About time someone at a pharmaceutical firm dug out the trials of desoxypipradrol and looked at it again - I know self administration in a non-clinical setting is hardly a recommendation, but the incidences I've seen of coke seeking behaviour being effectively abolished by administration of low doses of desoxypipradrol (and some were long time coke users) surely make it something worth re-evaluating considering the current lack of a maintainance drug for cocaine dependant people
Click to expand...

Sigh...

If only someone at the NIDA would read this.

To my friends who kindly suggest NON pharmacological interventions - thank you.
I am well aware of CBT interventions being more effective to date. (I can, in fact suggest a great self help book).

I simply hope to flesh out any biological possibilities.

If for example desoxypipradrol became attainable and were helpful to me? I would make it my mission to persuade someone to study it.

Regarding DXM - my only experience was high dose - resulting in sleep for 2 days. That someone has personally found low doses helpful is also most interesting.
(similar personal experiences?)


Thanks!
- WZ
 
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