Topiramate for the treatment of methamphetamine addiction: a multi-center placebo-controlled trial.
OBJECTIVE
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.


METHODS
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.


METHODS
The trial was conducted at eight medical centers in the United States.


METHODS
One hundred and forty methamphetamine-dependent adults took part in the trial.


METHODS
The primary outcome was abstinence from methamphetamine during weeks 6-12. Secondary outcomes included use reduction versus baseline, as well as psychosocial variables.


RESULTS
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.
National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20892, USA.
Ahmed
A
Elkashef
Roberta
R
Kahn
Elmer
E
Yu
Erin
E
Iturriaga
Shou-Hua
SH
Li
Ann
A
Anderson
Nora
N
Chiang
Nassima
N
Ait-Daoud
David
D
Weiss
Frances
F
McSherry
Tracey
T
Serpi
Richard
R
Rawson
Mark
M
Hrymoc
Dennis
D
Weis
Michael
M
McCann
Tony
T
Pham
Christopher
C
Stock
Ruth
R
Dickinson
Jan
J
Campbell
Charles
C
Gorodetzky
William
W
Haning
Barry
B
Carlton
Joseph
J
Mawhinney
Ming D
MD
Li
Bankole A
BA
Johnson
D000328:Adult; D019969:Amphetamine-Related Disorders / Q000534:rehabilitation*; D004311:Double-Blind Method; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use*; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D018682:GABA Agents / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008694:Methamphetamine; D008875:Middle Aged; D011594:Psychometrics; D000077236:Topiramate; D016896:Treatment Outcome; D055815:Young Adult
D018691:Excitatory Amino Acid Antagonists; D018682:GABA Agents; D000077236:Topiramate; D005632:Fructose; D008694:Methamphetamine