Topiramate for the Treatment of Dually Dependent on Opiates and Cocaine: A Single-center Placebo-controlled Trial

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PIRNIA BIJAN; SOLEIMANI ALI AKBAR; MALEKANMEHR PARASTOO; PIRNIA KAMBIZ; ZAHIRODDIN ALIREZA

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Journal: Iranian Journal of Public Health Year:2018 | Volume:47 | Issue:9 Page(s): 1344-1352

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Title

Topiramate for the Treatment of Dually Dependent on Opiates and Cocaine: A Single-center Placebo-controlled Trial

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Keywords

Topiramate

Anticonvulsants and adverse effects

Methadone maintenance treatment

Cocaine

Opioid

Abstract

Background: Topiramate facilitates gamma aminobutyric acid (GABA) transference and an ideal candidate for reducing Cocaine use in methadone patients. The present study evaluated Topiramate in Dual dependence on opiate and Cocaine. Methods: This placebo-controlled study (Clinical Trial Registration Code: TCTR20170201001) conducted during the period 2013– 2014, Cocaine-dependent individuals maintained on methadone (n=50) were randomized to re-ceive Topiramate or identical placebo capsules. Participants' dosage ranged between 25-300 mg/day (12 wk) in esca-lating doses. Methadone Doses started at 30 mg/day (median 100 mg/day; range 20 – 140 mg/day). In addition, all subjects received brief behavioral compliance enhancement treatment (BBCET). The data were analyzed by Chi-square Test, generalized estimating equations (GEE) models, linear mixed effects (LME) model and Analysis of covariance (ANCOVA). Primary outcome measures included twelve weekly urine drug screens (Cocaine abstinence, detection of benzoylecgonine) and treatment retention. Secondary outcome measures included correlation between Cocaine craving with Cocaine urine samples and Side effects of depression. Results: Topiramate was not better than placebo in reducing Cocaine use. The secondary outcome showed that Topiramate was better than placebo in reducing Cocaine craving. The mean [99% confidence interval (CI)] scores of Cocaine craving were 24. 31 (18. 61– 30. 01) in experimental group and 21. 84 (16. 86– 26. 81) in control group (all P > 0. 01). Retention and correlation between Cocaine craving and Cocaine urine samples were not significantly different between the groups. Topiramate usage was not associated with increase in depression symptoms as a side effect (P>0. 05). Conclusion: The efficacy of Topiramate in Cocaine treatment is limited and needs the similar controlled clinical trials and can be used as a complementary intervention.

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APA: Copy

PIRNIA, BIJAN, SOLEIMANI, ALI AKBAR, MALEKANMEHR, PARASTOO, PIRNIA, KAMBIZ, & ZAHIRODDIN, ALIREZA. (2018). Topiramate for the Treatment of Dually Dependent on Opiates and Cocaine: A Single-center Placebo-controlled Trial. IRANIAN JOURNAL OF PUBLIC HEALTH, 47(9), 1344-1352. SID. https://sid.ir/paper/274882/en

Vancouver: Copy

PIRNIA BIJAN, SOLEIMANI ALI AKBAR, MALEKANMEHR PARASTOO, PIRNIA KAMBIZ, ZAHIRODDIN ALIREZA. Topiramate for the Treatment of Dually Dependent on Opiates and Cocaine: A Single-center Placebo-controlled Trial. IRANIAN JOURNAL OF PUBLIC HEALTH[Internet]. 2018;47(9):1344-1352. Available from: https://sid.ir/paper/274882/en

IEEE: Copy

BIJAN PIRNIA, ALI AKBAR SOLEIMANI, PARASTOO MALEKANMEHR, KAMBIZ PIRNIA, and ALIREZA ZAHIRODDIN, “Topiramate for the Treatment of Dually Dependent on Opiates and Cocaine: A Single-center Placebo-controlled Trial,” IRANIAN JOURNAL OF PUBLIC HEALTH, vol. 47, no. 9, pp. 1344–1352, 2018, [Online]. Available: https://sid.ir/paper/274882/en

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