Antiseizure Drug May Help Treat Cocaine Addiction

Results of recent research suggest that combining the antiseizure medication topiramate with one form of behavioral therapy may effectively treat cocaine addiction. Researchers with the University of Pennsylvania School of Medicine in Philadelphia enrolled 40 people in a 13- week, placebo-controlled, double-blind study. Participants received placebo or an escalating daily dose of topiramate for 8 weeks (they initially received a dose of 25 mg daily, which was increased by 25 mg per week until the maximum dose of 200 mg per day was reached during the 8th week of the study). This maximum once-daily dose was maintained through week 12. During week 13, the dose of the drug was decreased daily until participants were weaned from it.

All study participants also received twice-weekly, individual, cognitive-behavioral relapse prevention therapy. In cognitive-behavioral therapy, patients learn to confront the consequences of their drug use by recognizing the environmental cues and potentially stressful situations that trigger strong drug cravings, and develop avoidance strategies.

The scientists reported that participants who received topiramate were more likely than those who received a placebo to be cocaine-abstinent after the 8th week of the study. In addition, data from the 36 people who returned for at least one evaluation visit after starting medications showed that those who received topiramate and counseling were significantly more likely to achieve 3 or more weeks of continuous cocaine abstinence compared with those who received placebo and counseling (59 percent vs. 26 percent, respectively).

WHAT IT MEANS: A recognized treatment for seizure disorders, topiramate also has been studied for treatment of alcoholism and opiate dependence. This study, however, is one of the first to explore its usefulness as a potential treatment for cocaine addiction. This study is important because it demonstrates that topiramate can successfully produce a stable period of cocaine abstinence. Previous research indicates that achieving a stable period of continuous cocaine abstinence is a predictor of long-term abstinence.

Dr. Kyle Kampman led this NIDA-funded study.

Source: Was published online in May, 2004 in Drug and Alcohol Dependence.

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