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pmid22221594      Addiction 2012 ; 107 (7): 1297-306
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  • Topiramate for the treatment of methamphetamine addiction: a multi-center placebo-controlled trial #MMPMID22221594
  • Elkashef A; Kahn R; Yu E; Iturriaga E; Li SH; Anderson A; Chiang N; Ait-Daoud N; Weiss D; McSherry F; Serpi T; Rawson R; Hrymoc M; Weis D; McCann M; Pham T; Stock C; Dickinson R; Campbell J; Gorodetzky C; Haning W; Carlton B; Mawhinney J; Li MD; Johnson BA
  • Addiction 2012[Jul]; 107 (7): 1297-306 PMID22221594show ga
  • 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.
  • |*Methamphetamine[MESH]
  • |Adult[MESH]
  • |Amphetamine-Related Disorders/*rehabilitation[MESH]
  • |Double-Blind Method[MESH]
  • |Excitatory Amino Acid Antagonists/*therapeutic use[MESH]
  • |Female[MESH]
  • |Fructose/*analogs & derivatives/therapeutic use[MESH]
  • |GABA Agents/*therapeutic use[MESH]
  • |Humans[MESH]
  • |Male[MESH]
  • |Medication Adherence[MESH]
  • |Middle Aged[MESH]
  • |Psychometrics[MESH]
  • |Topiramate[MESH]
  • |Treatment Outcome[MESH]


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