Topiramate in opiate withdrawal.
The alpha2-adrenergic agonist clonidine is the mainly used drug for the opiate withdrawal. Its efficacy and tolerance in treating withdrawal symptoms is, however, suboptimal. The pharmacological profile of topiramate suggests it could be rather valuable for opiate withdrawal, as there is some evidence that topiramate acts, among others, through inhibition of alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptors, which play an important role in the withdrawal-induced activation of the locus coeruleus (LC) by glutamate. Three patients undergoing an inpatient opiate detoxification program were treated with topiramate, which achieved a nearly complete control of withdrawal symptoms.
Zullino
Daniele F
DF
Division of Substance Abuse, University Department of Adult Psychiatry, Prilly-Lausanne, Switzerland. Daniele.Zullino@inst.hospvd.ch
Cottier
Anne-Claude
AC
Besson
Jacques
J
D000316:Adrenergic alpha-Agonists / Q000009:adverse effects / Q000627:therapeutic use; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D003000:Clonidine / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D006556:Heroin Dependence / Q000523:psychology; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D009293:Opioid-Related Disorders / Q000523:psychology* / Q000534:rehabilitation; D012640:Seizures / Q000188:drug therapy / Q000209:etiology; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy* / Q000523:psychology; D000077236:Topiramate
D000316:Adrenergic alpha-Agonists; D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose; D003000:Clonidine