Effective Experimental Treatment for Cocaine Addiction - a Medication Cocktail of Topirimate and Amphetamines

We don’t yet have a single medication to really help people quit cocaine. Maybe that’s the problem, say researchers at Columbia University: no single medication works, but a combination of two different meds might just do the trick.

• Topirimate is an anti seizure medication that has been proven effective against alcohol and nicotine addiction. It has also shown some ability to disrupt cocaine addiction, but it works quite slowly - and on its own, doesn’t work quite well enough.
• There is also some evidence that amphetamines, like modafinil, can ameliorate some of the brain changes caused by cocaine addiction, like reduced executive control and disrupted reward functioning – but amphetamines alone have not proven effective in helping people quit cocaine.

But what if you mixed the 2 drugs together?

The Study

The researchers recruited a group of cocaine addicted people who were looking to get addiction treatment and divided this group in 2 segments:

• For 120 days, half of the study subjects received a combination of topirimate and amphetamines
• For 120 days, the other half of the subjects received a placebo.
• All subjects received addiction treatment psychotherapy

Neither the subjects nor the researchers knew which subjects were receiving the placebo.

The Results

• Subjects getting the medications were twice as likely to achieve three weeks of continuous abstinence (33%, compared to only 17% of the subjects who received the placebo).
• Subjects getting the topirimate and amphetamines also used cocaine on significantly fewer days over the study period than subjects getting only placebo

Commentary

The researchers say the results show the promise of this 2 medication treatment for cocaine addiction and they call for larger clinical studies to continue to test its efficacy.

Read the full study results in the current edition of Biological Psychiatry