Topiramate in the Treatment of Substance-Related Disorders

Shinn, Ann K.; Greenfield, Shelly F.

doi:10.4088/jcp.08r04062gry

Cited by 105 publications

(32 citation statements)

References 74 publications

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“…agoraphobia with panic attacks / diabetes / lipomatosis / migraine / topiramate / weight loss In 1996 the anticonvulsant drug topiramate was approved by the US Food and Drug Administration (FDA) and has also gained importance in the prevention of migraine [1][2][3]. Moreover, topiramate was investigated as a treatment in personality disorders, alcoholism and substance addiction, for instance to cocaine or methamphetamines [4,5]. A common side-effect of topiramate, its anorectic effect, gradually became a clinical treatment option for obesity [6], which has led to the successful use of a topiramate-phentermine formulation in adult obesity [7][8][9].…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, topiramate was investigated as a treatment in personality disorders, alcoholism and substance addiction, for instance to cocaine or methamphetamines [4,5]. A common side-effect of topiramate, its anorectic effect, gradually became a clinical treatment option for obesity [6], which has led to the successful use of a topiramate-phentermine formulation in adult obesity [7][8][9].…”

Section: Agoraphobia With Panic Attacks / Diabetes / Lipomatosis / MImentioning

confidence: 99%

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Effectiveness of topiramate in lipomatosis comorbid with agoraphobia and migraine. Case study

Koch¹

2015

Arch Psych Psych

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SummaryTopiramate has been used in epilepsy and migraine for more than ten years. Recently, it has gained importance in the treatment of obesity, particularly in combination with phentermine. We report the case of a 51-year-old woman suffering from agoraphobia with panic attacks, diabetes and migraine. In addition, she simultaneously developed generalized lipomatosis leading to a weight gain of more than 20[th]kg. She was given topiramate up to 100[th]mg per day in addition to an SSRI (citalopram) and a melatoninergic drug (agomelatine). Gradually, within two years after starting topiramate, she lost 20[th]kg, with a corresponding reduction of thorax and arm circumference. Although the mechanism of weight loss remains to be clarified, topiramate may be an alternative approach in patients suffering from generalized lipomatosis. agoraphobia with panic attacks / diabetes / lipomatosis / migraine / topiramate / weight lossIn 1996 the anticonvulsant drug topiramate was approved by the US Food and Drug Administration (FDA) and has also gained importance in the prevention of migraine [1][2][3]. Moreover, topiramate was investigated as a treatment in personality disorders, alcoholism and substance addiction, for instance to cocaine or methamphetamines [4,5]. A common side-effect of topiramate, its anorectic effect, gradually became a clinical treatment option for obesity [6], which has led to the successful use of a topiramate-phentermine formulation in adult obesity [7][8][9]. In psychiatry topiramate was also assessed in post-traumatic stress and bipolar disorders or social phobia, without unambiguous effects [10][11][12].Topiramate has a bioavailability of approximately 80% and reaches the maximum concentration within 2 to 4 hours after oral administration. Oral dosage starts low, with 25 mg s.i.d. or b.i.d. and is gradually increased to daily doses of up to 100 mg in migraine and 400 mg in epilepsy. About 80% of the dose is excreted unchanged in urine with a half-life of approximately 20 hours. The pharmacology of this unusual anticonvulsant, whose chemical structure is a sulfamate-substituted monosaccharide, has not yet been completely expounded [1]. Analogously to acetazolamide, topiramate inhibits the carboanhydrase isoenzymes, blocks voltage sensitive sodium channels (VSSC), increases the activity of gamma-aminobutyric acid (GABA)-A receptors and decreases the activity of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptor or kainite (i.e. glutamate) receptors [13,14]. Apart from the inhibition of carboanhydrase, topiramate inhibits the CYP2C19

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Section: Discussionmentioning

confidence: 99%

Section: Agoraphobia With Panic Attacks / Diabetes / Lipomatosis / MImentioning

confidence: 99%

Effectiveness of topiramate in lipomatosis comorbid with agoraphobia and migraine. Case study

Koch¹

2015

Arch Psych Psych

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“…Thus it has been proposed that medications that affect GABA neurotransmission may be useful as pharmacological treatments for tobacco addiction [175,176]. One example is topiramate which inhibits glutamatergic neurotransmission, reduces fast inward voltage-gated sodium currents [177], and enhances GABAergic tone by direct action on GABA-A receptors [178,179]. Topiramate is approved for the treatment of epilepsy and has been shown to be efficacious for bipolar disorder, post-traumatic stress disorder and eating disorders (e.g.…”

Section: Drugs That Affect Gamma-aminobutyric Acid (Gaba) Transmissionmentioning

confidence: 99%

New Pharmacological Agents to Aid Smoking Cessation and Tobacco Harm Reduction: What Has Been Investigated, and What Is in the Pipeline?

et al. 2016

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A wide range of support is available to help smokers to quit and aid attempts at harm reduction, including three first-line smoking cessation medications: nicotine replacement therapy, varenicline and bupropion. Despite the efficacy of these, there is a continual need to diversify the range of medications so that the needs of tobacco users are met. This paper compares the first-line smoking cessation medications to: 1) two variants of these existing products: new galenic formulations of varenicline and novel nicotine delivery devices; and 2) twenty-four alternative products: cytisine (novel outside of central and eastern Europe), nortriptyline, other tricyclic antidepressants, electronic cigarettes, clonidine (an anxiolytic), other anxiolytics (e.g. buspirone), selective 5-hydroxytryptamine Key points: This paper reviews 26 pharmacotherapies that have been investigated for tobacco harm reduction and smoking cessation alongside three first-line treatments (nicotine replacement therapy, varenicline and bupropion) on six criteria: relative efficacy, relative safety, relative cost, relative use, relative scope, and relative ease of use. Although many of these products are in the early stages of clinical trials, of all the medications considered, cytisine appears to offers the best prospect for the future, having established safety and efficacy and being very inexpensive. Electronic cigarettes have become very popular in some countries but efficacy and long-term safety compared with other treatment profiles require further consideration.

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“…L'acamprosate, un autre traitement pour la dépendance à l'alcool, contribuerait à rétablir l'équilibre du système glutamatergique et à aider les personnes alcooliques à demeurer abstinentes. Le topiramate s'est aussi démontré efficace pour diminuer le craving dans des cas de consommation abusive chez les individus dépendants à l'alcool, notamment par son effet modulateur du système glutamatergique (Muller, Geisel, Banas et Heinz, 2014 ;Shinn et Greenfield, 2010). La méthadone, quant à elle, diminuerait sans toutefois complètement soulager le craving lorsqu'utilisée chez les patients dépendants aux opiacés (Fareed et al, 2011).…”

Section: Implications Dans La Rechute Et Avenues Thérapeutiquesunclassified

Le craving comme symptôme central de la toxicomanie : de ses fondements neurobiologiques à sa pertinence clinique

Morissette

Ouellet‐Plamondon

Jutras‐Aswad

2014

smq

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Le craving, ce désir intense de consommer, est un symptôme central de la toxicomanie. Jusqu’au début des années 2000, peu d’outils existaient afin d’étudier le phénomène de manière plus concrète pour mieux le définir, le comprendre et approfondir les fondements neurobiologiques qui le sous-tendent. Avec les avancées technologiques des dernières années (IRM fonctionnelle, PET Scan), puis l’arrivée du DSM-V et son inclusion comme critère diagnostique des troubles liés à l’utilisation de substances, le craving est devenu un symptôme central en toxicomanie. Sa définition a évolué et est de plus en plus précise à plusieurs égards. Nous avons une meilleure compréhension des voies neurobiologiques impliquées dans le phénomène ainsi qu’une meilleure compréhension des facteurs capables de le déclencher. Finalement, plusieurs travaux ont évoqué le rôle du craving dans la rechute lors de l’abstinence, et quelques traitements pharmacologiques se sont démontrés efficaces afin d’atténuer ce symptôme et éviter la rechute. Le craving s’avère ainsi une cible de choix afin de trouver de nouvelles avenues thérapeutiques pour briser le cycle de la dépendance.Objective: Observed by physicians and often reported by patients, craving is a core symptom of addiction, although not well defined nor understood completely. In the last several years, functional imaging as well as the measurement of different biological substrates of addiction have greatly evolved, allowing for a better understanding of the underlying neurobiological pathways of craving. Furthermore, with the development of the DSM-V and its inclusion as a diagnostic criterion for substance use disorders, craving has gained a whole new level of interest. Hence, the general objective of this article is to examine findings of studies that have led to a better understanding of craving and its implications. First, we address the definition of craving and its epidemiology in individuals with substance use disorders. We then summarize the results of the research conducted on the neurobiological substrates of craving. Finally, we present the role of craving in the cycle of addiction and its potential as a therapeutic target for pharmacological and non-pharmacological interventions.Methods: Narrative review of the literature.Results: The definition of craving has greatly evolved throughout the years, and it is commonly described as an abnormal desire or need to take a drug. While its conscious aspect is well known, whereas it is expressed subjectively, it is growingly also defined as an unconscious phenomenon illustrated by a physiologic activation that is not perfectly correlated with subjective measures. Available data on craving have also demonstrated the presence of this symptom in all three phases of the addiction cycle, including early and prolonged abstinence, long after the acute physical withdrawal syndrome. Three factors have been identified as potent craving inducers: the drug itself, drug related cues and stress. PET scan studies and fMRI studies confirmed the implication ...

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Topiramate in the Treatment of Substance-Related Disorders

Cited by 105 publications

References 74 publications

Effectiveness of topiramate in lipomatosis comorbid with agoraphobia and migraine. Case study

Effectiveness of topiramate in lipomatosis comorbid with agoraphobia and migraine. Case study

New Pharmacological Agents to Aid Smoking Cessation and Tobacco Harm Reduction: What Has Been Investigated, and What Is in the Pipeline?

Le craving comme symptôme central de la toxicomanie : de ses fondements neurobiologiques à sa pertinence clinique

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