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Published on: January 22, 2016
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Topiramate impairs cognitive function in methadone-maintained individuals with concurrent cocaine dependence
Olga Rass1, Annie Umbricht1, George E Bigelow1
1Behavioral Pharmacology Research Unit, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine.
Summary
Topiramate may impair cognitive functions like processing speed and memory in individuals with cocaine and opioid use disorders. These cognitive side effects could limit its use as a treatment for addiction.
Area of Science:
- Neuroscience
- Psychopharmacology
- Addiction Medicine
Background:
- Topiramate is explored for treating addictive disorders.
- Cognitive side effects of topiramate are a concern, particularly in individuals with pre-existing cognitive impairments common in chronic substance use disorders.
Purpose of the Study:
- To investigate the cognitive effects of topiramate in individuals with dual cocaine and opioid dependence.
- To assess topiramate's impact on cognitive functions during treatment for cocaine dependence.
Main Methods:
- A double-blind, randomized, controlled trial involving 40 participants dually dependent on cocaine and opioids.
- Participants received daily methadone stabilization followed by randomization to topiramate (300 mg) or placebo for 10-13 weeks.
- Cognitive testing was conducted at baseline and during stable dosing, 2 hours post-medication administration.
Main Results:
- Topiramate significantly slowed psychomotor and information processing speed.
- Impairments were observed in divided attention and n-back working memory accuracy.
- Topiramate increased false alarm rates in recognition memory but did not affect other cognitive domains.
Conclusions:
- Topiramate may induce cognitive impairment in individuals with chronic cocaine and opioid use disorders.
- These cognitive effects could restrict the clinical utility and patient acceptance of topiramate for treating these populations.
- Further research is needed to weigh the benefits against the cognitive risks in addiction pharmacotherapy.
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