Can Topiramate Help People Addicted To Crack Cocaine?
Topiramate (Topamax) is a prescription medication originally developed as a treatment for certain seizure disorders. Doctors also sometimes prescribe this medication to people affected by other serious health issues, including alcohol addiction. In a study published in May 2014 in the journal Drug and Alcohol Dependence, researchers from two Dutch institutions explored the potential usefulness of topiramate as a treatment for people addicted to crack cocaine. These researchers found that only a small subset of individuals addicted to this form of cocaine clearly benefit from topiramate use.
How Does Topiramate Work?
Specific seizure disorders treated with topiramate include Lennox-Gastaut syndrome and certain forms of epilepsy. The medication helps people affected by these conditions by easing excessive nerve activity inside the brain. This same effect on brain function can also help stop migraine headaches from occurring.
When given to people affected by alcoholism, topiramate can diminish the severity of some of the symptoms associated with alcohol withdrawal, and can thereby help reduce the likelihood that a recovering alcoholic will lapse back into active drinking. Doctors may also prescribe the medication to people affected by medically serious forms of obesity. Available forms of topiramate include tablets and specially designed granules that users can release from a capsule and mix with food.
Topiramate And Cocaine Addiction
There is no medication in doctors’ treatment arsenals approved to help people affected by cocaine addiction. Instead, successful treatment typically depends on a form of behavior modification therapy called cognitive behavioral therapy or on other non-medication-based therapeutic options. Addiction researchers are actively looking for new medications that could help people addicted to cocaine, as well as existing medications that could be adapted for use in cocaine addiction treatment.
In a study published in October 2013 in the American Medical Association journal JAMA Psychiatry, a multi-university research team studied the effects of topiramate on 71 adults impacted by cocaine addiction. These researchers concluded that, compared to recovering addicts who don’t receive the medication while undergoing cognitive behavioral therapy, those who receive both topiramate and cognitive behavioral therapy experience improvements that include longer periods of cocaine abstinence (verified by an increased number of cocaine-free urine drug tests) and a reduced craving for further cocaine intake.
Potential Usefulness Of Topiramate In Crack Cocaine Treatment
Crack cocaine is powdered cocaine that has undergone an additional step of chemical processing. While the two forms of the drug have the same basic brain effects, crack only produces these effects for a relatively brief amount of time. This means that users of this form of cocaine may take the drug more frequently, and therefore may have greater odds of eventually experiencing the long-term brain changes associated with cocaine addiction.
In the study published in Drug and Alcohol Dependence, researchers from Parnassia Addiction Research Centre and the University of Amsterdam specifically investigated the potential usefulness of topiramate treatment in people addicted to crack cocaine. Thirty-seven participants in the study received a 12-week combination of topiramate and cognitive behavioral therapy, while another thirty-seven participants only received cognitive behavioral therapy.
The researchers mainly measured the effectiveness of topiramate treatment by comparing the rate of continued program involvement among recipients of the medication to the rate of continued involvement among those who did not receive the medication.
Variance Factors In Topiramate Use
In addition, they assessed such things as the regularity with which participants took their prescribed topiramate, the presence of negative side effects in the topiramate users, the ability to avoid using cocaine or other substances, the ability of medication users to interact in socially appropriate ways and the level of satisfaction that the topiramate recipients expressed toward use of the medication.
After completing their assessments, the researchers found that topiramate didn’t produce any serious side effects in the study participants. However, they also found that most of the medication recipients did not take it on a regular basis. In addition, they concluded that use of topiramate neither increased the length of involvement in cocaine addiction treatment nor generally contributed to a reduction in the consumption of cocaine or any other substance.
Critically, one group affected by crack cocaine addiction did benefit from topiramate use: those individuals simultaneously impacted by an addiction to opioid drugs or medications. This subset of addicts significantly lowered their cocaine intake while taking topiramate.
Importance Of Consistency Of Topiramate Use
The authors of the study published in Drug and Alcohol Dependence link the low level of topiramate effectiveness in crack cocaine addicts to highly inconsistent intake of the medication. Because many people in treatment don’t maintain their medication routines, the authors believe that topiramate may only play a relatively minor role in addressing the effects of crack cocaine addiction.
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