There’s new hope for people struggling with an addiction to cocaine. In clinical trial results released today, an experimental drug developed by Novartis was found to reduce cocaine use in people with cocaine use disorder.
Scientists at Novartis led the research, a Phase II trial of 68 people with diagnosed cocaine use disorder. Compared to those on a placebo, people taking the experimental treatment—called mavoglurant—used cocaine and also drank alcohol less often over the following three months. The findings require further validation, but mavoglurant could eventually become the first approved drug intended to treat cocaine use disorder.
Cocaine and similar drugs like methamphetamine or prescription stimulants are frequently abused. In the U.S., it’s estimated that 10.2 million Americans over the age of 12 misused stimulants in 2022, while about 4.5 million people met the criteria for a stimulant use disorder (continued long-term use even when it’s actively harming a person’s health and relationships). Stimulant misuse also appears to be rising, and these drugs are contributing to growing overdose deaths as well, particularly when combined with other drugs like opioids.
Currently, the only widely recommended treatments available for helping people with stimulant misuse are psychosocial, such as counseling or cognitive behavioral therapy. There are no approved medications for reducing people’s urges to use cocaine, and off-label options like disulfiram have shown limited effectiveness overall. So there’s an urgent need to fill this treatment gap—one that could possibly be filled with mavoglurant.
Mavoglurant was originally developed to treat the genetic condition Fragile X, though it ultimately failed to do so in large clinical trials. The drug is known to block a receptor called mGluR5, which some studies have suggested plays a role in regulating our reward response to stimulants. Novartis researchers hoped that mavoglurant could be retrofitted into a treatment for stimulant use disorder.
In this latest trial, the researchers randomized people with cocaine use disorder to either receive a placebo or mavoglurant (taken as a pill) twice a day for 98 days. Cocaine use was measured through self-reported use as well as urine and hair tests that looked for known byproducts of the drug in the body.
Overall, the researchers found that mavoglurant significantly reduced cocaine use compared to placebo, which was supported by urine tests. They also found evidence, though not as clear, that it reduced people’s alcohol use as well. The drug seemed to be generally safe and tolerated, with common adverse events including headache, dizziness, and nausea.
“In this small and short trial, mavoglurant reduced cocaine and alcohol use in patients with chronic cocaine use disorder,” the researchers wrote in their paper, published in Science Translational Medicine.
As the authors note, this is only one small trial. So larger, more diverse, and longer-lasting trials will be needed to confirm the findings. Given the current lack of options, however, this research could be an important step forward for the treatment of stimulant use disorder. The potential effects it may have on people’s alcohol use also suggest that mGluR5 might also play a larger role in regulating how we respond to alcohol, which could open a new avenue of research.
English (US) ·