Topiramate in opiate withdrawal

Prog Neuropsychopharmacol Biol Psychiatry. 2002 Oct;26(6):1221-3. doi: 10.1016/s0278-5846(02)00251-8.

Abstract

The alpha2-adrenergic agonist clonidine is the mainly used drug for the opiate withdrawal. Its efficacy and tolerance in treating withdrawal symptoms is, however, suboptimal. The pharmacological profile of topiramate suggests it could be rather valuable for opiate withdrawal, as there is some evidence that topiramate acts, among others, through inhibition of alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionic acid (AMPA) receptors, which play an important role in the withdrawal-induced activation of the locus coeruleus (LC) by glutamate. Three patients undergoing an inpatient opiate detoxification program were treated with topiramate, which achieved a nearly complete control of withdrawal symptoms.

Publication types

  • Case Reports

MeSH terms

  • Adrenergic alpha-Agonists / adverse effects
  • Adrenergic alpha-Agonists / therapeutic use
  • Adult
  • Anticonvulsants / adverse effects
  • Anticonvulsants / therapeutic use*
  • Clonidine / adverse effects
  • Clonidine / therapeutic use
  • Female
  • Fructose / adverse effects
  • Fructose / analogs & derivatives*
  • Fructose / therapeutic use*
  • Heroin Dependence / psychology
  • Humans
  • Liver Function Tests
  • Male
  • Opioid-Related Disorders / psychology*
  • Opioid-Related Disorders / rehabilitation
  • Seizures / drug therapy
  • Seizures / etiology
  • Substance Withdrawal Syndrome / drug therapy*
  • Substance Withdrawal Syndrome / psychology
  • Topiramate

Substances

  • Adrenergic alpha-Agonists
  • Anticonvulsants
  • Topiramate
  • Fructose
  • Clonidine