Topiramate Did Not Increase Abstinence from Methamphetamine but Might Reduce Use
Topiramate has shown promise for the treatment of cocaine dependence. This study randomized 140 methamphetamine-dependent adults from 8 sites to 13 weeks of topiramate (50 mg per day increasing to ≤200 mg per day) or placebo. All subjects received counseling to enhance adherence.
- Intent-to-treat analyses did not show differences in abstinence during weeks 6 to 12.
- More subjects in the topiramate (64%) than placebo (42%) group reduced their weekly median quantitative urine methamphetamine levels by ≥25% from baseline (p=0.05) during weeks 6 to 12.
- More subjects in the topiramate (38%) than placebo (14%) group reported a ≥50% reduction in methamphetamine use from baseline (p=0.003) during weeks 6 to 12.
- Subjects in the topiramate group experienced improved observer-rated global severity-of-dependence scores and had a trend toward decreased craving.
- Topiramate was associated with increased paresthesias and dysgeusia but was generally well-tolerated.