Craving Decrease with Topiramate in Outpatient Treatment for Cocaine Dependence:an open label trial.
Diminuição da Fissura com Topiramato no Tratamento Ambulatorial para Dependência de Cocaína: um Ensaio Clínico Aberto.
Alessandra Diehl ReisI, Luiz André Castro , Roberta Faria , Ronaldo Laranjeira.
Objectives: Evaluate anti-craving action and tolerability of topiramate in cocaine user treatment.
Methods: Male users of inhaled cocaine (N=28) which met criteria from DSM IV (Diagnostic and Statistical Manual of Mental Disorders, fourth edition) for cocaine dependence were selected for outpatient 12 week, open label trial with topiramate, individual dosage varied (25to300mg/day). Main clinical variables were: abstinence rate, craving intensity, frequency and duration, adherence, dropouts, side effects and impulsivity measure through Barratt Impulsivity Scale (BIS11). Patients received assertive strategic counseling for abstinence assistance and medication monitoring evaluation every two weeks. Comparative analysis was made with Intention to Treat, missing values were replaced (LOCF – Last Observation Carried Forward), significance level was 5%.Results: Adherence to treatment was 57% (at least three evaluations), 32% dropped out (one evaluation). There were no severe side effects. Negative test average was 25.4%+31.2.Significant statistical reduction regarding duration was (p=0,012), and craving intensity (p=0,018). Craving frequency was not significant (p=0,783). No significant statistical variations in BIS11 or in the total score were found in the final evaluation when compared to baseline (p>0,05).