rebalancing the serotonergic system in cocaine dependence

Conditions: Cocaine Dependence

Summary: in the united states, 1.5 million people abuse cocaine leading to a host of negative health and economic consequences, yet no fda approved treatment exists. to develop effective treatments, the following must be considered: 1) do potential medications ameliorate brain disruptions associated with cocaine use? 2) are multiple, targeted treatments necessary? to meet these goals, innovative multi-modal neuroimaging will be used to determine whether rebalancing the serotonergic (5-ht) system reduces cocaine cue reactivity, impulsivity, and normalizes related neurochemistry and brain connectivity.


Eligibility criteria:
inclusion criteria: * - participants will be male and female volunteers between the ages of 18-55 * participants will report having used cocaine on at least four occasions within the month prior to screening; the urine sample obtained during the screening visit must be positive for the cocaine metabolite benzoylecgonine (\>300 ng/ml). they can meet dsm-iv criteria for cocaine abuse and dependence. * participants cannot meet dsm-iv criteria for current psychotic disorders (e.g., bipolar disorder, schizophrenia, schizoaffective disorder) * participants cannot meet dsm-iv criteria for a current major depressive episode * participants cannot meet dsm-iv criteria for current drug dependence (except nicotine, cocaine, and marihuana) * participants must test negative for alcohol use on the day of the scan. * participants can report current abuse of marihuana and tobacco. participants cannot have used marihuana within twelve hours of their study visits. * participants cannot be regular opiate users including prescription opiate analgesics * participants cannot have a history of major head trauma resulting in cognitive impairment, seizure, or other neurological disorders. * participants cannot have any conditions that are contraindicated for mri (see next section) * participants cannot be pregnant (pregnancy test will be performed before each scanning session) * participants must be able to read screening materials including consent form and give informed consent * participants cannot be taking any medications with a 5-ht mechanism including serotonin-norepinephrine reuptake inhibitors (snris), selective serotonin reuptake inhibitors (ssris), tricyclic antidepressants (tcas), monoamine oxidase inhibitors (maois) and st. john's wort and tryptophan. * participants cannot be currently taking any medications that might affect the central nervous system including prescription analgesics, anxiolytics, antipsychotics, and antidepressants. a complete review of medications will be evaluated by study staff. * cannot have any history of a medical condition that might affect the central nervous system at the time of scanning including: abnormal structural mri, or a history of head trauma or injury causing loss of consciousness lasting longer than 3 minutes or associated with skull fracture or intracranial bleeding or who had irremovable magnetically active objects on or within their body, or history of epilepsy. exclusion criteria: * - weight greater than 350 pounds (cannot easily fit inside the magnet bore) * cardiac pacemakers * aneurysm clips and other vascular stents, filters, clips or other devices * prosthetic heart valves * other prostheses * neuro-stimulator devices * implanted infusion pumps * cochlear implants * ocular implants or known metal fragments in eyes * exposure to shrapnel or metal filings (sheet metal workers, welders, and others) * other metallic surgical hardware in vital areas * history of major head trauma resulting in cognitive impairment * certain tattoos (e.g. older dye with metallic pigment) * certain medication patches (if they cannot be removed) * metal containing iuds * claustrophobia * pregnancy * metallic implants except fillings and crowns * tattoos containing metallic ink on the neck, shoulders, upper arm, and head (these could become heated during scanning, potentially causing burns * medication patches that cannot be removed during scanning * claustrophobia