A recent study published in the journal Drug and Alcohol Dependence reports that the drug topiramate may help people battling cocaine addiction. More specifically, the study showed that people suffering from both cocaine and alcohol dependence may be more successful in treatment and use less cocaine if they are prescribed topiramate. These findings largely agree with previous, separate studies that also show topiramate’s potential usefulness for treating cocaine and alcohol addictions. However, this most recent study is the first to look at the drug’s effectiveness for people dealing with both dependencies at the same time.

What Is Topiramate?

Topiramate is an anticonvulsant drug that was discovered in 1979. It was approved by the Food and Drug Administration (FDA) in 1996 and has been primarily used to manage seizures in patients with epilepsy. Topiramate has also been frequently prescribed to prevent migraine headaches. In 2012, the FDA also approved topiramate for use as a weight-loss drug in combination with the drug phentermine.

One of the effects of topiramate is an increase in the amount of gamma-Aminobutyric Acid, or GABA, in the brain. This substance is a neuro-inhibitor, and researchers now hope that using topiramate to increase GABA levels may help limit the dopamine release that happens when people take cocaine or drink alcohol. This would reduce the euphoric feelings that result from these substances, and make it easier for people to resist cravings and fight addiction.

Details Of The New Study

Researchers in the psychiatry department of the Perelman School of Medicine at the University of Pennsylvania created and published the new topiramate study. These researchers were assisted by the Charles O’Brien Center for Addiction Treatment.

The study took place over 13 weeks, with the participation of 170 people who experienced both cocaine and alcohol dependence. The majority of the participants in the study were African-American males, and participants had an average age of 45.

Some of the patients were treated with topiramate, while others were given a placebo. The study employed a double-blind set-up, in which neither the patients nor the researchers knew who was taking the drug versus the placebo. This allowed researchers to examine the true effectiveness of the drug at reducing cravings, reducing overall consumption of cocaine and alcohol, and helping patients stay in treatment.

Mixed Results

At the conclusion of the study, researchers found both positive and neutral results for the effectiveness of topiramate. Patients who received the drug were more likely to remain in treatment and less likely to use cocaine during the last three weeks of the trial than those who received the placebo. Twenty percent of the participants on topiramate were able go without cocaine during the study, compared to only 7 percent of the participants on the placebo. Patients who had the worst withdrawal symptoms in the past seemed to benefit the most from topiramate.

However, the drug was not better than the placebo at reducing cocaine cravings. In addition, the drug did not help patients reduce their drinking even though they generally reported reduced alcohol cravings.

These results were somewhat surprising, since past studies have shown that topiramate did help people with alcohol dependence. The researchers in the Perelman School of Medicine have speculated that these poor results may reflect the low number of heavy drinkers who participated in the study. In past studies, the average number of days of heavy drinking among the study participants was much higher. It may be that topiramate is more effective for people who are very heavy drinkers.

What Is Next For Topiramate?

Although topiramate studies have been promising, additional research is needed to determine whether the drug can be a useful long-term tool for fighting cocaine and alcohol dependence. Researchers plan to perform more studies in order find out whether topiramate is effective when paired with additional drugs. By combining different drugs that have shown moderate success, researchers hope to produce even more impressive results for a greater percentage of patients.

Ultimately, larger scale studies will be necessary before the FDA can approve topiramate for additional treatment purposes.

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