A seizure medication may offer hope for people struggling with cocaine addiction, more research needed

published on August 11, 2016

Vancouver, B.C. [August 11, 2016] Topiramate, a medication normally used to treat seizures and prevent migraines, appears to show some promise in the treatment of cocaine addiction.

Research scientists from the Urban Health Research Initiative (UHRI), part of the BC Centre for Excellence in HIV/AIDS (BC-CfE), as well as the Division of Global Public Health at the University of California San Diego, have published findings in the August issue of the international medical journal Addiction detailing results from a systematic review and meta-analysis of the most current evidence on the efficacy of topiramate (brand name Topamax®) for the treatment of cocaine use disorder. Researchers assessed the effectiveness of topiramate therapy in randomized control trials by analyzing six global scientific databases for retention in treatment, efficacy and safety of the medication as well as reduction in cocaine craving.

Over 14 million people worldwide are estimated to use cocaine, with the drug being linked to a host of health and social harms, including stroke, heart problems, HIV infection, and more. Cocaine use is associated with the highest number of emergency room visits of all illegal drugs in the United States. Unlike opioids and alcohol addiction, where effective pharmacotherapy treatment options exist, researchers and scientists have yet to find a medication to treat those who suffer from cocaine use disorder. To date, no drug has been proven to effectively reduce cocaine use and cravings. The findings published today demonstrate a strong signal that Topiramate may show promise and will help set the stage for future studies aimed at identifying evidence-based treatment options for cocaine addiction.

“It is still too early to come to any definitive conclusions, but according to some of these findings, it appears topiramate may in some cases promote higher rates of cocaine abstinence,” said lead co-authors Dr. Daniel Werb, from the University of California San Diego and Dr. Jan Klimas, an Associate Director of the Canada Addiction Medicine Research Fellowship and a Postdoctoral Fellow with the UHRI.

Topiramate is believed to help individuals control cravings for cocaine by markedly enhancing the activity of gamma-aminobutyric acid, or GABA, receptors in the brain. GABA is a neurotransmitter that sends chemical messages through the nervous system, and is involved in regulating communication between brain cells. People with cocaine addiction have less inhibitory GABA in their brains so medications like topiramate that increase GABA, have shown some effectiveness in treating addiction such as cocaine and alcohol.

“As we work to develop recovery-oriented solutions, strategies to address the severe cravings that go along with cocaine addiction are clearly needed,” said co-author Dr. Evan Wood, Professor of Medicine at the University of British Columbia, Medical Director of Addiction Services at Vancouver Coastal Health and Providence Health Care, Director of the UHRI, BC-CfE, and a senior author on the paper.

Data from five U.S. topiramate studies were investigated, which involved 518 patients averaging 13 weeks (range: 8-24 weeks) who were enrolled in cocaine addiction trials. Although patients did not report longer stays in treatment, some findings suggested topiramate could help people to stay cocaine-free for longer. The authors have cautioned, however, further research is needed to enhance understanding of medications like topiramate and their clinical utility in treating cocaine addiction.

Read the complete study “Topiramate for cocaine dependence: a systematic review and meta-analysis of randomized controlled trials” published in the journal Addiction: http://onlinelibrary.wiley.com/doi/10.1111/add.13328/full. Read complete commentary at http://onlinelibrary.wiley.com/doi/10.1111/add.13369/full.

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About the Urban Health Research Initiative
The Urban Health Research Initiative (UHRI) is an innovative research program of the BC Centre for Excellence in HIV/AIDS based on a network of studies developed to help identify and understand the many factors that affect the health of urban populations. Focusing primarily on issues relating to substance abuse, infectious diseases, the urban environment and homelessness, UHRI aims to improve the health of individuals and communities through research to inform policy. Founded in 2007, UHRI’s team consists of researchers, epidemiologists, statisticians, ethnographers, research assistants, research coordinators, registered nurses, knowledge translations coordinators, students, and support staff.

About the British Columbia Centre for Excellence in HIV/AIDS
The BC Centre for Excellence in HIV/AIDS (BC-CfE) is Canada’s largest HIV/AIDS research, treatment and education facility and is internationally recognized as an innovative world leader in combating HIV/AIDS and related diseases. BC-CfE is based at St. Paul’s Hospital, Providence Health Care, a teaching hospital of the University of British Columbia. The BC-CfE works in close collaboration with key provincial stakeholders, including government, health authorities, health care providers, academics from other institutions, and the community to decrease the health burden of HIV and AIDS. By developing, monitoring and disseminating comprehensive research and treatment programs for HIV and related illnesses, the BC-CfE helps improve the health of British Columbians.

For additional information or to request interviews, please contact:
Diane Pépin, Communications Coordinator, BC-CfE
604-653-5673
Email: [email protected]

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