Historique
Périodique
A pilot trial of topiramate for the treatment of cocaine dependence
(Essai contrôlé d'utilisation du topiramate pour le traitement de la dépendance à la cocaïne)
Auteur(s) :
KAMPMAN, K. M. ;
PETTINATI H. ;
LYNCH, K. G. ;
DACKIS, C. ;
SPARKMAN, T. ;
WEIGLEY C. ;
O'BRIEN, C. P.
Année :
2004
Page(s) :
233-240
Langue(s) :
Anglais
Refs biblio. :
46
Domaine :
Drogues illicites / Illicit drugs
Thésaurus mots-clés
COCAINE
;
DEPENDANCE
;
MECANISME D'ACTION
;
NEUROTRANSMETTEURS
;
ANTICONVULSIVANTS
;
ESSAI THERAPEUTIQUE
Note générale :
Drug and Alcohol Dependence, 2004, 75, (3), 233-240
Note de contenu :
graph. ; tabl.
Résumé :
ENGLISH :
Background: Both GABAergic and glutamatergic neurons appear to be important modulators of the brain reward system and medications that affect GABA and glutamatergic neurotransmission may reduce the rewarding properties of cocaine and reduce cocaine craving. Topiramate, an anticonvulsant, raises cerebral GABA levels, facilitates GABAergic neurotransmission and inhibits glutametergic activity at AMPA/kainite receptors. Thus, it may be useful for treating cocaine dependence. Methods: The efficacy of topiramate for cocaine dependence was tested in a 13-week, double-blind, placebo-controlled pilot trial (n = 40). Topiramate was titrated gradually over 8 weeks to a dose of 200 mg daily. The primary outcome measure was cocaine abstinence verified by twice weekly urine benzoylecgonine tests (UBT). Results: Eighty-two percent of subjects completed the trial. Analysis of the UBT using a GEE model showed that after week 8, when the dose titration was completed, topiramate-treated subjects were more likely to be abstinent from cocaine compared to placebo-treated subjects (Z = 2.67, P = 0.01). Topiramate-treated subjects were also more likely to attain 3 weeks of continuous abstinence from cocaine (X2 = 3.9, d.f. = 1, P = 0.05). Conclusion: Topiramate may be effective for the treatment of cocaine dependence. (Review's abstract.)
Affiliation :
Dept. Psychiatry, Univ. PA Sch. Med., 3900 Chestnut Str., Philadelphia, PA 19104
Etats-Unis. United States.
Etats-Unis. United States.