Chronic cocaine use is known to be associated with decreased blood flow to the brain, which can produce consequences similar to those of major strokes, such as paralysis, speech impairments, cognitive impairment and, in the worst scenario, death. However, the mechanism behind the restriction of blood flow has remained a mystery.

A team from the Yale School of Medicine, led by Dr Thomas Kosten, believed that cocaine-induced constriction of arteries in the brain, which may co-exist with blood clotting, could be involved.

To test this, the team administered the diuretic amiloride, aspirin or a placebo to 49 cocaine-dependent patients over a period of one month. Blood flow in the brain was measured on admission to the research unit and at the end of treatment.

At the time they were enrolled in the study, the cocaine-dependent subjects showed decreased cerebral blood flow, compared to 18 control subjects. However, after four weeks of treatment, the researchers found that the amiloride improved blood flow in the brain, while the aspirin and placebo were ineffective.

The authors suggest that the improvement seen in the amiloride subjects may be due to the medication’s ability to dilate the arteries in the brain. And they say amiloride, in combination with other medications that also increase cerebral blood flow, could be used to treat cocaine-dependent patients.

Dr Kosten says that the patients in the study had reduced blood flow to the brain, which impaired their cognitive abilities and resulted in depressive symptoms. However, returning blood flow back to normal can reverse the symptoms, he says.

“These improvements in cognition can also enable these patients to return to productive employment and be active members of society,” Dr Kosten said.

Source: Drug and Alcohol Dependence

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