Effects of topiramate or naltrexone on tobacco use among male alcohol-dependent outpatients

Baltieri, Danilo Antônio; Daró, Fabio Ruiz; Ribeiro, Philip Leite; Andrade, Arthur Guerra de

doi:10.1016/j.drugalcdep.2009.05.025

Cited by 48 publications

(39 citation statements)

References 57 publications

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“…Four studies biochemically confirmed non-smoking status 19 20 23 24. Abstinence data were unpublished for two of the studies and obtained directly from the authors 21 22. For one of the studies, part of a multicentre trial with 350 participants enrolled at five centres in the USA, the authors only published the results from the Mayo Clinic site, which enrolled 100 people but would not provide unpublished data for the other study sites upon repeated requests (R Croop, personal communication to Dr. Robert Croop of DuPont Merck Pharmaceutical Company, 2000).…”

Section: Resultsmentioning

confidence: 91%

Systematic review and meta-analysis of opioid antagonists for smoking cessation

David

Lancaster

et al. 2014

BMJ Open

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ObjectivesThis meta-analysis sought to evaluate the efficacy of opioid antagonists in promoting long-term smoking cessation. Post-treatment abstinence was examined as a secondary outcome and effects on withdrawal symptoms, craving and reduced consumption were also explored.DesignThe search strategy for this meta-analysis included clinical trials (published and unpublished data) in the Cochrane Tobacco Addiction Group Specialized Register and MEDLINE.ParticipantsAdult smokers.InterventionsWe included randomised trials comparing opioid antagonists to placebo or an alternative therapy for smoking cessation and reported data on abstinence for a minimum of 6 months.Primary and secondary outcome measuresOutcomes included smoking abstinence at long-term follow-up (primary); abstinence at end of treatment (secondary); and effects on withdrawal, craving and smoking consumption (exploratory).Results8 trials with a total of 1213 participants were included. Half the trials examined the benefit of adding naltrexone versus placebo to nicotine replacement therapy (NRT). There was no significant difference between naltrexone and placebo alone (relative risk (RR) 1.00; 95% CI 0.66 to 1.51) or as an adjunct to NRT (RR 0.95; 95% CI 0.70 to 1.30), with an overall pooled estimate of RR 0.97; 95% CI 0.76 to 1.24. Findings for naltrexone effects on withdrawal, craving and reduced smoking were equivocal.ConclusionsThe findings indicate no beneficial effect of naltrexone alone or as an adjunct to NRT on short-term or long-term smoking abstinence. While further trials may narrow the confidence limits, they are unlikely to appreciably alter the conclusion.

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Section: Resultsmentioning

confidence: 91%

Systematic review and meta-analysis of opioid antagonists for smoking cessation

David

Lancaster

et al. 2014

BMJ Open

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“…A secondary analysis of an 8-week placebo-controlled, randomized clinical trial examining the safety and efficacy of topiramate for patients with schizoaffective disorder, bipolar type, showed a lack of effect on smoking in this subtype of patients (Weinberger et al, 2008). Finally, Baltieri et al (2009) found a reduction in cigarette smoking among alcoholic patients treated with topiramate. In conclusion, data on the use of topiramate for smoking cessation are potentially promising, but more research is needed to test this role of topiramate.…”

Section: Topiramatementioning

confidence: 99%

Novel Therapeutic Strategies for Alcohol and Drug Addiction: Focus on GABA, Ion Channels and Transcranial Magnetic Stimulation

Addolorato

Leggio

Hopf

et al. 2011

Neuropsychopharmacol

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Drug addiction represents a major social problem where addicts and alcoholics continue to seek and take drugs despite adverse social, personal, emotional, and legal consequences. A number of pharmacological compounds have been tested in human addicts with the goal of reducing the level or frequency of intake, but these pharmacotherapies have often been of only moderate efficacy or act in a sub-population of humans. Thus, there is a tremendous need for new therapeutic interventions to treat addiction. Here, we review recent interesting studies focusing on gamma-aminobutyric acid receptors, voltage-gated ion channels, and transcranial magnetic stimulation. Some of these treatments show considerable promise to reduce addictive behaviors, or the early clinical studies or pre-clinical rationale suggest that a promising avenue could be developed. Thus, it is likely that within a decade or so, we could have important new and effective treatments to achieve the goal of reducing the burden of human addiction and alcoholism.

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“…Studies have demonstrated the efficacy of topiramate for smoking cessation, particularly among men and alcoholic smokers [189][190][191]. An additional benefit may be the prevention of post-cessation weight gain [192].…”

Section: Relative Efficacymentioning

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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Effects of topiramate or naltrexone on tobacco use among male alcohol-dependent outpatients

Abstract: The results of this study confirm that the treatment is more challenging for smoking alcoholics than for non-smoking ones and support the efficacy of topiramate in the smoking reduction among male alcoholic smokers who adhered to the treatment.

Cited by 48 publications

References 57 publications

Systematic review and meta-analysis of opioid antagonists for smoking cessation

Systematic review and meta-analysis of opioid antagonists for smoking cessation

Novel Therapeutic Strategies for Alcohol and Drug Addiction: Focus on GABA, Ion Channels and Transcranial Magnetic Stimulation

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

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