Topiramate (Topamax), a drug often used to treat migraine headaches, is better than placebo in treating cocaine addiction. It was tested in a three-month double-blind placebo-controlled trial among 142 adults with cocaine dependence.
It certainly was not a cure. The subjects taking topiramate had 16 percent cocaine-free weeks as measured by urinary tests compared to not quite 6 percent for those taking placebo. The researchers had thought that the neurotransmitters affected by topiramate might offer a better pathway for treatment. While they may be on the right track, it seems that much more work is needed to provide addicts with a reliable treatment.
Topiramate has side effects, though in this context they may be considered much less serious than the side effects of cocaine abuse. Side effects may include:
- Changes in mood or behavior, depression, suicidal thoughts
- Confusion, cognitive dysfunction, difficulty concentrating or finding words, problems with memory
- Fatigue, tiredness, dizziness, spaciness, unsteadiness
- Skin reactions (can be serious or life threatening and require immediate medical attention)
- Tingling or numbness in hands or feet, muscle contractions
- Anxiety, nervousness, insomnia
- Digestive distress, heartburn, nausea, diarrhea, abdominal pain
- Metabolic acidosis (a condition caused by reduced bicarbonate in the blood); symptoms may include fatigue, loss of appetite, rapid breathing, chest pain, irregular heart rhythms, headaches, altered mental state, coma
- Visual disturbances, difficulty focusing, uncontrollable eye movements, double vision
- Changes in taste
- Hair loss
- Anorgasmia (inability to achieve sexual climax)