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.

[JAMA Psychiatry, Dec. 2013]

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
  • Osteoporosis
  • Anorgasmia (inability to achieve sexual climax)

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  1. Anonymous

    We really need a reliable relief for addicts. The suffering is unbearable & the only way to relieve it is more of the drug. With the technology today, you would think? I, myself, am a recovering alcoholic in a 12 step program. I am involved with all 12 step programs & watch what people go through because of addictions. It is devastating to all, family especially. My prayers go out to all suffering.

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