Cocaine exerts its most prevalent effects within a functionally separate
projection of dopamine neurons. As John mentioned, the pathogenesis of
Parkinson's disease is focused primarily in the Substantia Nigra System
of DA neurons. Cocaine exerts many of its effects on the Mesocorticolimbic
DA neurons. This system is more concerned with regulation of higher brain
function. Treating patients with cocaine, while it may very well excite
nigro-striatal pathways indirectly, would severely interfere with the
delicate regulation of certain very important processes such as cognition,
emotion, motivation, and attention.
Same is true with amphetamines.
Really, it would mess all sorts of other things up. Probably we should
just stick to L-DOPA for Parkinsons.
Now, in the case of schizophrenia, we may have another story, but I will not
go into that here.
Justin Baker
Brown University
