title: Craving decrease with topiramate in outpatient treatment for cocaine dependence: an open label trial.
abstract: OBJECTIVE
  To evaluate anticraving action and tolerability of topiramate in cocaine user treatment.
  
  
  METHODS
  Male users of inhaled cocaine which met criteria for cocaine dependence (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) were selected for outpatient 12-week, open label trial with topiramate; individual dosage ranged between 25-300 mg/day. Main clinical variables were abstinence rate, craving intensity, frequency and duration, adherence, dropouts, side effects and impulsivity measure through Barratt Impulsivity Scale. Patients received assertive strategic counseling for abstinence assistance and medication monitoring evaluation every two weeks. Comparative analysis was made with intention to treat, missing values were replaced (last observation carried forward), and significance level was 5%.
  
  
  RESULTS
  Adherence to treatment was 57% (at least three evaluations), 32% dropped out (one evaluation). There were no severe side effects. Negative test average was 25.4% (31.2). Significant reduction in craving intensity and duration was observed in 25% of the sample. No statistical significant reduction in craving frequency was observed in 7.1%. Increase in frequency was observed in 10.7% and 82.1% did not present any variation. No significant statistical variations in Barratt Impulsivity Scale or in the total score were found in the final evaluation when compared to baseline.
  
  
  CONCLUSIONS
  More randomized placebo-controlled trials with topiramate for cocaine dependants should be performed to evaluate preliminary evidence.
authors.affiliation: Unidade de Pesquisa em álcool e Drogas, Psychiatry Department, Escola Paulista de Medicina, Universidade Federal de São, São Paulo, SP, Brazil. alediehl@terra.com.br
authors.forename: Alessandra Diehl
authors.initials: AD
authors.lastname: Reis
authors.forename: Luiz André
authors.initials: LA
authors.lastname: Castro
authors.forename: Roberta
authors.initials: R
authors.lastname: Faria
authors.forename: Ronaldo
authors.initials: R
authors.lastname: Laranjeira
mesh_terms: D000328:Adult; D000553:Ambulatory Care; D016739:Behavior, Addictive / Q000188:drug therapy* / Q000523:psychology; D019970:Cocaine-Related Disorders / Q000188:drug therapy* / Q000523:psychology; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D018696:Neuroprotective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D010352:Patient Dropouts / Q000523:psychology; D012647:Self-Assessment; D013375:Substance Withdrawal Syndrome / Q000523:psychology*; D000077236:Topiramate
chemical_list: D018696:Neuroprotective Agents; D000077236:Topiramate; D005632:Fructose