Effects of topiramate on methamphetamine-induced changes in attentional and perceptual-motor skills of cognition in recently abstinent methamphetamine-dependent individuals

Abstract

Methamphetamine-dependent individuals often cite the need to maintain enhanced cognitive performance and attention as a reason for continuing or relapsing to drug-taking. Further, methamphetamine addicts might not comply with taking a potentially therapeutic medication if it had a profound effect on these cognitive processes. Topiramate, a sulfamate-substituted fructopyranose derivative, has been suggested as a putative therapeutic medication for treating methamphetamine dependence. Examination of topiramate's effects on cognitive performance and attention is a clinically and scientifically important component of understanding its potential therapeutic profile. In 10 male and female individuals who met DSM-IV criteria for methamphetamine dependence, we examined the effects of low (50 mg b.i.d.)-and high (100 mg b.i.d.)-dose topiramate -in both the presence and absence of low (15 mg)-and high (30 mg)-dose intravenous methamphetamine -on cognitive performance, attention, and concentration on the rapid visual information processing task and the digit symbol substitution test. Intravenous methamphetamine enhanced cognitive performance, attention, and concentration among recently withdrawn methamphetamine addicts -an effect that hitherto had not been well characterized. Topiramate's cognitive effects were mixed and rather paradoxical, with a tendency to improve attention and concentration both alone and in the presence of methamphetamine while worsening psychomotor retardation. No deleterious interaction occurred between topiramate and methamphetamine on any of these cognitive processes. While clinical studies with topiramate should Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access

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“…The findings are consistent with outcomes from similar intranasal studies: Kirkpatrick, Metcalfe, Greene, and Hart (2008) showed enhanced metacognition with methamphetamine (12 mg) while Rush et al (2011) reported improved visuospatial perception (10, 20 mg). Similar results have been found with the intravenous administration of methamphetamine abusers (Johnson et al, 2005(Johnson et al, , 2007. It is important to keep in mind that some individuals do take larger doses of methamphetamine and may well binge (i.e., multiple doses administered repeatedly) at higher doses than what has been studied to date (e.g., Cho, Melega, Kuczenski, & Segal, 2001).…”

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