October 26, 2013
Research Suggests Topiramate Could Treat Cocaine Addiction
redOrbit Staff & Wire Reports - Your Universe Online
A medication currently approved by the US Food and Drug Administration (FDA) to treat epilepsy and migraines could also be the first drug capable of effectively treating cocaine addiction, according to new research published in the journal JAMA Psychiatry.
Bankole A. Johnson, chairman of the Department of Psychiatry at the University of Maryland School of Medicine, and colleagues recruited 142 adults who were seeking treatment for cocaine dependence. Once accepted into the double-blind study, they were randomly given either the drug topiramate or a placebo.
“Using an intent-to-treat analysis, the researchers found that topiramate was more efficacious than placebo at increasing the participants' weekly proportion of cocaine nonuse days and in increasing the likelihood that participants would have cocaine-free weeks,” the university said Friday in a statement.
Similarly, Johnson’s team found a significant association between topiramate and both a decrease in craving for the drug and an improvement in the subjects’ overall level of functioning in comparison to a placebo. They also reported observing a few mild side-effects among those in the topiramate group, including abnormal skin-tingling sensations, distortions in taste, difficulty concentrating and anorexia.
“Our findings reveal that topiramate is a safe and robustly efficacious medicine for the treatment of cocaine dependence, and has the potential to make a major contribution to the global health crisis of addiction,” Johnson explained. “However, topiramate treatment also is associated with glaucoma, and higher doses of the drug can increase the risk of side effects; therefore, caution must be exercised when prescribing the drug, especially when given in high doses.”
The professor had previously found that topiramate was a safe and effective treatment for alcohol dependence when tested against placebo, and these latest results build upon previous research which found that cocaine-dependent men and women who were not seeking treatment were more likely to experience a reduced level of cravings and preference for cocaine when taking the epilepsy/migraine drug than when taking a placebo.
According to the university, the research – which was supported by the National Institutes of Health and Agency for Healthcare Research and Quality (AHRQ) – indicates that the medication could even be more effective in treating the addition of those actively looking to kick the habit. The research is said to be one of the first to seek out a pharmaceutical treatment to help the between 13 and 20 million people addicted to cocaine worldwide.
“Because topiramate is the first medication to demonstrate a robust therapeutic effect for the treatment of cocaine or alcohol dependence, its fundamental neurochemical effects provide important clues as to common links in the neurobiological basis of the addictive process in general,” Johnson said.
“These findings also add to our understanding of how addiction affects the brain because it demonstrates the unique concept that dual neurotransmitter modulation, by simultaneously augmenting the inhibitory action of gamma amino butyric acid and inhibiting the excitatory effects of glutamate, can result in therapeutic effects that reduce the propensity to use cocaine,” he added.