Discovery of New Drug Treatments

The article in this issue by LaRowe et al., “Is Cocaine Desire Reduced by N -Acetylcysteine?” describes a promising new pharmacological intervention to reduce cocaine cravings. Most articles on drug treatment in the Journal concern the use of drugs that are already available to psychiatrists and their patients. We publish these articles because they offer evidence-based recommendations on treatment. However, the vast strides in neurobiology and molecular biology of the past several decades are now being translated into new treatments that target mechanisms not exploited by existing drug treatments. LaRowe et al. used lessons learned in experimental neurobiology on the regulation of glutamate exchange with cysteine to design a new treatment for cocaine abuse, a condition that is notoriously insensitive to current pharmacological treatments. It is notable also that the development of this new treatment by a team of academic investigators was supported by the National Institute on Drug Abuse. Of interest, the National Institutes of Health and the Veterans Administration, along with funding from foundations such as the National Alliance for Research on Schizophrenia and Depression and Stanley, are supporting drug development programs that add to the long-standing interest of the pharmaceutical industry in new therapeutic development. At this early stage, the treatment described in this article is not available to patients in clinical settings, and the evidence is not strong enough to decide if the treatment will be effective outside experimental settings. We are publishing the article because we feel that this initial report advances the scientific evidence for the further development of this treatment and to let our readers know of this progress. We welcome other articles on the translational application of new neurobiological discoveries to improve the treatment of patients with mental illnesses.