Results of an initial clinical trial of varenicline for the treatment of cocaine dependence

Background: Cocaine use, abuse and dependence remains a pressing public health problem. Based on its mechanism of action, varenicline, an alpha4beta2 partial agonist seemed to be a likely candidate for treating cocaine dependence. Methods: Cocaine dependent participants (n=37) were enrolled in a 9-week double-blind placebo controlled clinical trial. Varenicline was titrated up to a target dose of 1. mg BID during the first week of medication. Results: Varenicline was associated with lower odds of cocaine use than placebo (OR =2.02, p=0.08), as measured by thrice-weekly urinalysis results. Compared to placebo-treated participants, varenicline treated participants had significantly decreased rates of cocaine reward, as measured by the Multiple Choice Procedure (MCP) (p=0.02). Conclusions: Varenicline appears to decrease cocaine use and reward, suggesting that further investigation of varenicline may be warranted.