Literature DB >> 22221594

Topiramate for the treatment of methamphetamine addiction: a multi-center placebo-controlled trial.

Ahmed Elkashef1, Roberta Kahn, Elmer Yu, Erin Iturriaga, Shou-Hua Li, Ann Anderson, Nora Chiang, Nassima Ait-Daoud, David Weiss, Frances McSherry, Tracey Serpi, Richard Rawson, Mark Hrymoc, Dennis Weis, Michael McCann, Tony Pham, Christopher Stock, Ruth Dickinson, Jan Campbell, Charles Gorodetzky, William Haning, Barry Carlton, Joseph Mawhinney, Ming D Li, Bankole A Johnson.   

Abstract

AIMS: Topiramate has shown efficacy at facilitating abstinence from alcohol and cocaine abuse. This double-blind, placebo-controlled out-patient trial tested topiramate for treating methamphetamine addiction.
DESIGN: Participants (n = 140) were randomized to receive topiramate or placebo (13 weeks) in escalating doses from 25 mg/day [DOSAGE ERROR CORRECTED] to the target maintenance of 200 mg/day in weeks 6-12 (tapered in week 13). Medication was combined with weekly brief behavioral compliance enhancement treatment.
SETTING: The trial was conducted at eight medical centers in the United States. PARTICIPANTS: One hundred and forty methamphetamine-dependent adults took part in the trial. MEASUREMENTS: The primary outcome was abstinence from methamphetamine during weeks 6-12. Secondary outcomes included use reduction versus baseline, as well as psychosocial variables.
FINDINGS: In the intent-to-treat analysis, topiramate did not increase abstinence from methamphetamine during weeks 6-12. For secondary outcomes, topiramate reduced weekly median urine methamphetamine levels and observer-rated severity of dependence scores significantly. Subjects with negative urine before randomization (n = 26) had significantly greater abstinence on topiramate versus placebo during study weeks 6-12. Topiramate was safe and well tolerated.
CONCLUSIONS: Topiramate does not appear to promote abstinence in methamphetamine users but can reduce the amount taken and reduce relapse rates in those who are already abstinent.
© 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

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Year:  2012        PMID: 22221594      PMCID: PMC3331916          DOI: 10.1111/j.1360-0443.2011.03771.x

Source DB:  PubMed          Journal:  Addiction        ISSN: 0965-2140            Impact factor:   6.526


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