Combinations of Dopamine D2 Receptor Blockade With Norepinephrine Reuptake Inhibition and with Norepinephrine Alpha 2 Receptor Blockade

Abstract

Methods of treating and or preventing substance abuse/dependence, and alcohol abuse/dependence in particular. Combinations of medications are also disclosed.

1 . A method of treating a patient with, or at risk for, alcohol or other substance abuse or dependence, by administering to the patient a composition comprising a combination of
 a) a dopamine D2 receptor antagonist; and   b) a norepinephrine reuptake inhibitor.   
     
     
         2 . The method of  claim 1  in which the composition further comprises a norepinephrine alpha 2 receptor antagonist. 
     
     
         3 . The method of  claim 1  in which the substances of abuse includes one or more of the following: alcohol, one or more opioids, cannabis, cocaine, amphetamines, tobacco. 
     
     
         4 . The method of  claim 3  in which the opioid is heroin, oxyContin®, or both. 
     
     
         5 . The method of  claim 1  in which the D2 receptor blockade is a weak dopamine D2 receptor antagonist (blocker). 
     
     
         6 . The method of  claim 1  in which the patient does not exhibit a co-occurring psychiatric disorder such as schizophrenia or bipolar disorder. 
     
     
         7 . The method of  claim 1  in which the patient exhibits a co-occurring psychiatric disorder such as schizophrenia or bipolar disorder. 
     
     
         8 . The method of  claim 1  in which the composition comprises as the dopamine D2 receptor antagonist activity, a drug selected from the group comprising risperidone, paliperidone, haloperidol, olanzapine, quetiapine, ziprasidone, aripiprazole, iloperidone, desmethylclozapine, fluphenazine, chlorpromazine, trifluoperizine, molindone, perphenazine, thioridazine, mesoridazine, raclopride, sulpiride, amisulpiride. 
     
     
         9 . The method of  claim 2  in which the composition comprises, as the norepinephrine alpha 2 receptor antagonist, idazoxan, yohimbine, atipamezole, mirtazapine, mianserin, methoxyidazoxan, phenoxybenzamine, buspirone, mianserin, 
     
     
         10 . The method of  claim 1  in which the composition comprises, as the norepinephrine reuptake inhibition, desipramine, reboxetine, nortriptyline, atamoxetine, maprotiline, nisoxetine, nomifensin, imipramine, bupropion, ketamine, bicifadine, n-desalkylquetiapine. 
     
     
         11 . A medicament comprising a) dopamine D2 receptor blockade (antagonism); and
 b) norepinephrine reuptake inhibition.   
     
     
         12 . The medicament of  claim 11  further comprising a norepinephrine alpha 2 receptor blockade (antagonism).