Leptin is a 16-kDa protein secreted from white adipocytes; it acts by binding to specific hypothalamic receptors to alter the expression of several neuropeptides regulating neuroendocrine function, food intake and the whole body energy balance. Actually leptin is considered a modulator of withdrawal-induced craving in alcoholic subjects. We studied the hypothesis that leptin might modulate cocaine craving in detoxified cocaine abusers, evaluating any possible correlation with metabolic, hormonal and psychometric parameters.

A sample of 50 cocaine dependent subjects, according to DSM-IV-TR, has been evaluated as follows: Body Mass Index, blood pressure, heart rate, substance and drug consumption, triglicerides, cholesterol, plasma leptin value, cortisol, insulin, ACTH, FT3, FT4, TSH and: SHAPS (Snaith Hamilton Pleasure Scale), VASc/f/s (Visual-Analogue-Scale for cocaine/food/sex), CCQ (Cocaine-Craving-Questionnaire), Barratt Impulsiveness Scale, HAM-D, HAM-A at baseline and after 15 days of abstinence.

Leptin levels, corrected for the BMI, resulted positively correlated with CCQ (p<.05). CCQ was positively correlated with VASc (p<.001). SHAPS was positively correlated with VASc (p<.05), CCQ (p<.05), HAM-A (p<.05) and HAM-D (p<.05). Finally HAM-A was negatively correlated with VASs (p<.05). These data are confirmed even after 15 days from baseline.

In our sample leptin correlates with cocaine craving measured by CCQ, independently from the hypothalamic-pituitary-adrenal axis. At baseline VASc (mean) was less than VAS f and s mean score, confirming the shifting craving phenomenon. Although our data confirm the correlation between leptin and cocaine craving, further studies are required.