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document
Topiramate impairs cognitive function in methadone-maintained individuals with concurrent cocaine dependence . Topiramate is being investigated as a potential pharmacotherapy for the treatment of addictive disorders . However , its cognitive side effects raise concerns about its use , especially in populations with cognitive impairment , such as persons with chronic substance use disorders . This study investigated topiramate 's cognitive effects in individuals dually dependent on cocaine and opioids as part of a double-blind , randomized , controlled trial of topiramate for cocaine dependence treatment . After 5 weeks of stabilization on daily oral methadone ( M = 96 mg ) , participants were randomized to topiramate ( n = 18 ) or placebo ( n = 22 ) . Cognitive testing took place at 2 time points : study weeks 4 through 5 to assess baseline performance and 10 to 13 weeks later to assess performance during stable dosing ( 300 mg topiramate or placebo ) . All participants were maintained on methadone at both testing times , and testing occurred 2 hours after the daily methadone plus topiramate/placebo administration . The topiramate and placebo groups did not differ on sex , level of education , premorbid intelligence , methadone dose , or illicit drug use . Topiramate slowed psychomotor and information processing speed , worsened divided attention , reduced n-back working memory accuracy , and increased the false alarm rate in recognition memory . Topiramate had no effects on visual processing , other measures of psychomotor function , risk-taking , self-control , Sternberg working memory , free recall , and metamemory . These findings indicate that topiramate may cause cognitive impairment in this population . This effect may limit its acceptability and use as a treatment in individuals with chronic opioid and cocaine use disorders , among whom preexisting cognitive impairments are common . ( PsycINFO Database Record
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Intervention_Pharmacological
Topiramate
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Intervention_Pharmacological
Topiramate
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Intervention_Pharmacological
pharmacotherapy
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Intervention_Pharmacological
topiramate 's
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Intervention_Pharmacological
topiramate
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Intervention_Pharmacological
methadone
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Intervention_Pharmacological
topiramate
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Intervention_Control
placebo
68586
Intervention_Pharmacological
topiramate
68587
Intervention_Control
placebo
68588
Intervention_Pharmacological
topiramate/placebo
68589
Intervention_Pharmacological
topiramate
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Intervention_Control
placebo
68591
Intervention_Pharmacological
Topiramate
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Intervention_Pharmacological
Topiramate
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Outcome_Mental
psychomotor and information processing speed , worsened divided attention , reduced n-back working memory accuracy , and increased the false alarm rate in recognition memory .
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Outcome_Mental
visual processing , other measures of psychomotor function , risk-taking , self-control , Sternberg working memory , free recall , and metamemory .
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Outcome_Mental
cognitive impairment
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Outcome_Other
may limit its acceptability
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Participant_Condition
concurrent cocaine dependence
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Participant_Condition
chronic substance use disorders
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Participant_Condition
dually dependent on cocaine and opioids
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Participant_Sample-size
18 )
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Participant_Sample-size
22
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Participant_Condition
chronic opioid and cocaine use disorders