Topiramate prevents ecstasy consumption: a case report.

The last decade has witnessed a development in the phenomenon 'ecstasy'. Several substances, with more or less the same effects, are grouped together by the term ecstasy, the best-known one being 3,4-methylenedioxymethamphetamine (MDMA). The psychopathological consequences of MDMA in humans are relatively poorly understood. In addition, the treatment approach is complicated by the lack of documented studies. Topiramate is an antiepileptic drug that has a broad spectrum of antiseizure effects, which appear to be the result of several neurostabilizing pharmacological mechanisms including facilitation of GABAergic neurotransmission and inhibition of glutametergic activity at AMPA/kainate receptors. As both GABAergic and glutametergic neurons appear to be important modulators of the brain reward system, it was postulated that topiramate would be an effective treatment for reducing MDMA consumption through the attenuation of MDMA-induced euphoria. The case of an ecstasy consumer, who started to discontinue ecstasy under topiramate treatment is presented here. Antiepileptics/mood stabilizers with glutamate inhibition activity like topiramate may present a promising new approach for challenging the consequence of drug abuse.