Cocaine addiction exacts devastating personal, societal, and economic costs. However, despite decades of research and numerous clinical trials, FDA approved treatments for cocaine use disorder are nonexistent. Given these failures, a potentially efficient strategy for identifying effective treatments for cocaine addiction is to repurpose pharmacotherapies that have already been FDA approved for other indications. This approach is particularly advantageous when existing preclinical and/or clinical research supports the mechanism of the FDA approved drug as a modulator of cocaine-related behaviors. One example is drugs targeting L-type calcium channels (LTCC), which have been implicated in a number of neuropsychiatric disorders including drug addiction [1]. In rodent models, blockade of LTCCs has been shown to attenuate cocaine reinforcement [2] as well as the reinstatement of cocaine seeking [3], an animal model of relapse.

In this issue of Neuropsychopharmacology, Addy et al. [4] explored the LTCC inhibitor isradipine (DynaCirc, Prescal), which is FDA approved for the treatment of hypertension, as a potential modulator of relapse-like behavior. In their model, rats were trained to self-administer cocaine and evaluated for cocaine cue-evoked drug seeking following 10 days of forced abstinence. Systemic or intra-ventral tegmental area (VTA) administration of isradipine attenuated cocaine reinstatement. The current work also showed, importantly, that intra-VTA isradipine did not alter sucrose seeking, suggesting that the ability of this drug to suppress cocaine seeking is at least somewhat reinforcer specific and not due to general motor impairment. Interestingly, delivery of isradipine into the VTA immediately prior to a cocaine self-administration session did not alter cocaine intake. To interpret these preclinical data in terms of translational potential, the LTCC inhibitor isradipine may help prevent cocaine relapse but apparently would not be efficacious as a cessation aid during periods of active drug taking.

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