Epilepsy drug may help treat cocaine addiction

Scientists have found that a drug used to treat epilepsy and migraine headaches could also be the first reliable medication to treat cocaine dependence.
Topiramate, a drug approved by the US Food and Drug Administration (FDA) may decrease cocaine craving, researchers found.
The study, led by Bankole A Johnson, chairman of the Department of Psychiatry at the University of Maryland School of Medicine, is one of the first to establish a pharmacological treatment for cocaine addiction, for which there are currently no FDA-approved medications.
Addiction affects 13.2 to 19.7 million cocaine users worldwide. Cocaine harms the brain, heart, blood vessels, and lungs - and can even cause sudden death.

The study enrolled 142 participants, aged 18 years or older, seeking treatment for cocaine dependence. Following enrolment, participants were randomly assigned into a topiramate group or placebo group.
Neither the participants nor the healthcare professionals administering the treatment knew who was in which group (double-blinded study).

Using an intent-to-treat analysis, the researchers found that topiramate was more efficacious than placebo at increasing the participants' weekly proportion of cocaine non-use days and in increasing the likelihood that participants would have cocaine-free weeks.
Furthermore, compared with placebo, topiramate also was significantly associated with a decrease in craving for cocaine and an improvement in participants' global functioning.

"Our findings reveal that topiramate is a safe and robustly efficacious medicine for the treatment of cocaine dependence, and has the potential to make a major contribution to the global health crisis of addiction," Johnson said.
"However, topiramate treatment also is associated with glaucoma, and higher doses of the drug can increase the risk of side effects; therefore, caution must be exercised when prescribing the drug, especially when given in high doses," Johnson added.
The research was published in JAMA Psychiatry.