Topiramate in opiate withdrawal- comparison with clonidine and with carbamazepine/mianserin.

Abstract:

UNLABELLED:There are some rationales for developing anticonvulsants for the treatment of substance abuse. The blockade of the AMPA/kainate subtype of glutamate receptor by topiramate may be of particular interest, as preclinical studies of withdrawal from opioids suggest that whilst AMPA-receptor antagonists may not be able to prevent tolerance or dependence from developing, they may ameliorate both physical and emotional consequences of withdrawal. METHODS:Ten consecutively admitted patients treated with topiramate were compared in a retrospective naturalistic drug utilization observation study with 10 consecutively admitted patients treated with clonidine and with 10 consecutively admitted patients treated with a carbamazepine/ mianserin combination. RESULTS:In 9 cases of the clonidine group and in 7 carbamazepine/mianserin treated patients the dose had been reduced, whereas this occurred in only 2 topiramate treated patients (p < 0.01). Patients in the topiramate group received less p.r.n. myorelaxant medication than the two other groups, and there was a significant difference between the three groups with regard to p.r.n. analgesics (p < 0.05), topiramate and clonidine treated patients receiving fewer analgesics than the carbamazepine/mianserin group. CONCLUSIONS:Compared to clonidine and carbamazepine/mianserin, a detoxification scheme using high initial and then decreasing doses of topiramate appeared to be appropriate for most patients and as associated with less analgesic and myorelaxant comedication, indicating a more promising efficacy at the used doses.

journal_name

Subst Abus

journal_title

Substance abuse

authors

Zullino DF,Krenz S,Zimmerman G,Miozzari A,Rajeswaran R,Kolly S,Khazaal Y

doi

10.1300/j465v25n04_04

subject

Has Abstract

pub_date

2004-12-01 00:00:00

pages

27-33

issue

4

eissn

0889-7077

issn

1547-0164

journal_volume

25

pub_type

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