title: Topiramate for the management of methamphetamine dependence: a pilot randomized, double-blind, placebo-controlled trial.
abstract: To date, no medication has been approved as an effective treatment for methamphetamine dependence. Topiramate has attracted considerable attention as a treatment for the dependence on alcohol and stimulants. Therefore, this study aimed to evaluate the effect of topiramate for methamphetamine dependence. This study was a double-blind, randomized, placebo-controlled trial. In the present investigation, 62 methamphetamine-dependent adults were enrolled and randomized into two groups, and received topiramate or a placebo for 10 weeks in escalating doses from 50 mg/day to the target maintenance dose of 200 mg/day. Addiction severity index (ASI) and craving scores were registered every week. The Beck questionnaire was also given to each participant at baseline and every 2 weeks during the treatment. Urine samples were collected at baseline and every 2 weeks during the treatment. Fifty-seven patients completed 10 weeks of the trial. There was no significant difference between both groups in the mean percentage of prescribed capsules taken by the participants. At week six, the topiramate group showed a significantly lower proportion of methamphetamine-positive urine tests in comparison with the placebo group (P = 0.01). In addition, there were significantly lower scores in the topiramate group in comparison with the placebo group in two domains of ASI: drug use severity (P < 0.001) and drug need (P < 0.001). Furthermore, the craving score (duration) significantly declined in the topiramate patients compared to those receiving the placebo. In conclusion, the results of this trial suggest that topiramate may be beneficial for the treatment of methamphetamine dependence.
authors.affiliation: Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Pasdaran Blvd, Sanandaj, Iran.
authors.forename: Farzin
authors.initials: F
authors.lastname: Rezaei
authors.affiliation: Social Determinants of Health Research Center, Kurdistan University of Medical Sciences, Pasdaran Blvd, Sanandaj, Iran.
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Ghaderi
authors.affiliation: Student Research Committee, Kurdistan University of Medical Sciences, Pasdaran Blvd, Sanandaj, Iran.
authors.forename: Roya
authors.initials: R
authors.lastname: Mardani
authors.affiliation: Ghods Hospital, Kurdistan University of Medical Sciences, Pasdaran Blvd, Sanandaj, Iran.
authors.forename: Seiran
authors.initials: S
authors.lastname: Hamidi
authors.affiliation: Cellular and Molecular Research Center, Kurdistan University of Medical Sciences, Pasdaran Blvd, Sanandaj, Iran.|Department of Physiology and Pharmacology, Faculty of Medicine, Kurdistan University of Medical Sciences, Pasdaran Blvd, Sanandaj, Iran.
authors.forename: Kambiz
authors.initials: K
authors.lastname: Hassanzadeh
mesh_terms: D000328:Adult; D019969:Amphetamine-Related Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D000697:Central Nervous System Stimulants / Q000009:adverse effects; D019468:Disease Management; D004311:Double-Blind Method; D005500:Follow-Up Studies; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D008694:Methamphetamine / Q000009:adverse effects*; D010865:Pilot Projects; D000077236:Topiramate
chemical_list: D000697:Central Nervous System Stimulants; D000077236:Topiramate; D005632:Fructose; D008694:Methamphetamine
keywords: clinical trial; methamphetamine dependence; topiramate