Dopaminergic and Glutamatergic Mechanisms in Addiction: Assessing the Therapeutic Promise of Memantine and Galantamine for Maintenance Treatment: A Review

Addiction comes in various forms and can be related to substances like cocaine, opioids, alcohol, cannabis, amphetamine, and nicotine, as well as behaviors like gambling or sex addiction. The impact of addiction places increased economic and medical burdens on society. Currently, the management of addiction is more focused on symptomatic relief rather than targeting the reinforcing mechanisms of dependence on addictive substances and behaviors. The aim of this review is to identify the specific roles of dopamine and glu- tamate in addiction, which can guide us to treat the cause rather than the symptoms. The synergistic effect of glutamate and dopamine neurotransmitters plays a crucial role in the development of pathological neuroplasticity in the mesolimbic system, causing compul- sive consumption of the substance. Utilizing the brain’s natural synthesis of substances such as Kynurenic acid (KYNA) derivatives could potentially disrupt the synergistic effect of glutamate and dopamine. By blocking glutamate release and increasing dopamine release, individuals may experience reward or pleasure without the need for addictive substances. Under this pretext, the review article explores the possibility of memantine and galantamine as maintenance treatment for addiction of various forms.