Combined Topiramate and Mixed Amphetamine Salts for Cocaine Use Disorder

Two medications that show efficacy for promoting cocaine abstinence when used alone also work in combination.

Prescribed stimulants and topiramate have had mixed results in treating cocaine use disorder (CUD). Individuals with higher impulsivity may be especially responsive to both (NEJM JW Psychiatry Apr 2019 and Am J Addict 2019; 28:71; NEJM JW Psychiatry Jul 2018 and Drug Alcohol Depend 2018; 188:135). Because a small study showed that the combination of the two medications reduced use in heavy users, researchers conducted a larger trial.

The 127 participants (mean age, 46; 96 men), who had CUD and used cocaine at least 9 days during the previous 28, were randomized to extended-release methamphetamine salts (titrated to 60 mg over 2 weeks) plus twice-daily topiramate (titrated to 100 mg over 6 weeks) or to double placebo for 12 weeks. Patients wi…

Reviewing Author

Claire Wilcox, MD

Disclosures

EquityMannkind Corporation

Grant/Research SupportNIH

Claire Wilcox, MD

Disclosures

EquityMannkind Corporation

Grant/Research SupportNIH

Combined Topiramate and Mixed Amphetamine Salts for Cocaine Use Disorder

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Reviewing Author