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Addiction. 2012 Jul;107(7):1297-306. doi: 10.1111/j.1360-0443.2011.03771.x. Epub 2012 Feb 28.

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

Author information

  • 1National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20892, USA.

Erratum in

  • Addiction. 2012 Sep;107(9):1718. Dosage error in published abstract; MEDLINE/PubMed abstract corrected.

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.

Comment in

PMID:
22221594
[PubMed - indexed for MEDLINE]
PMCID:
PMC3331916
Free PMC Article
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