Topiramate for smoking cessation

Abstract

Due to its AMPA ( α -amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid)/kainate antagonism, topiramate would be particularly interesting in addiction treatment. Flexible-dose topiramate was prescribed to 13 smokers (10 smokers who wanted to stop smoking, and three who received topiramate for other reasons). Six out of 13 smokers were abstinent at 2 months and two more subjects had reduced their cigarette consumption by > 50%. With one exception, temporary reduction of the number of smoked cigarettes preceded definitive abstinence at month 2. Three more subjects who achieved a momentary reduction had, however, to interrupt the treatment due to intolerable sideeffects. Controlled trials are needed to confirm these preliminary observations.

Effects of Topiramate on Smoking in Patients With Schizoaffective Disorder, Bipolar Type

“…The relationship between topiramate and smoking has not, to our knowledge, been previously investigated for this group of smokers. Our findings are consistent with a lack of an effect as reported by Anthenelli et al 5 but contrast the higher rates of abstinence and reduced smoking found by Johnson et al 3 and Khazaal et al 4 . Interestingly, psychotic and mood symptoms in these smokers with schizoaffective disorder were also unaffected (see Changappa et al, 2007 9 .…”

“…Few trials have examined topiramate specifically for smoking cessation and findings from these studies have been mixed. Khazaal et al 4 reported that six out of 13 smokers given topiramate (maximum dose 50-225 mg/day for n=11, 500 mg/day for n=1, and 800 mg/day for n=1) were abstinent from smoking after two months with two additional participants reducing their smoking significantly (>50%). In contrast, Anthenelli et al 5 found a trend (p=0.10) towards differences in smoking abstinence with topiramate (200 mg/day) versus placebo in male adult smokers (n=38); however, there was no difference in smoking abstinences rates for female smokers (n=49) by treatment group.…”

Novel Therapeutic Strategies for Alcohol and Drug Addiction: Focus on GABA, Ion Channels and Transcranial Magnetic Stimulation

“…Trials investigating topiramate as a specific treatment for smoking cessation led to controversial results. In particular, Khazaal et al (2006) found a significant rate of smoking cessation in a small sample of patients treated with topiramate, while Anthenelli et al (2006) did not find statistical differences between topiramate and placebo, although a trend of reduction in smoked cigarettes was found in male smokers treated with topiramate. A secondary analysis of an 8-week placebo-controlled, randomized clinical trial examining the safety and efficacy of topiramate for patients with schizoaffective disorder, bipolar type, showed a lack of effect on smoking in this subtype of patients (Weinberger et al, 2008).…”

Topiramato: efectos secundarios a nivel ocular. Revisión a propósito de un caso

“…Entre otras indicaciones se encuentran principalmente el tratamiento del Síndrome de Lenox-Gastaut, prevención de la migraña, trastorno bipolar 1 , tratamiento de la obesidad (al reducir la ingesta incontrolada) y bulimia nerviosa 2 , alcoholismo 3 , trastornos por estrés postraumático 4 , espasmo infantil 5 , cefalea en racimos 6 , tabaquismo 7 , tratamiento del dolor neuropático, especialmente neuralgia del trigémino 8 y síndrome piernas inquietas 9 . Tras su administración oral es rápidamente absorbido, y la mayor parte del fármaco (70%) se excreta en la orina sin modificaciones.…”