Impulsiveness as a predictor of topiramate response for cocaine use disorder
Impulsiveness as a predictor of topiramate response for cocaine use disorder
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DOI：
10.1111/ajad.12858
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发表时间：
2019-03-01
影响因子：
3.7
通讯作者：
Ait-Daoud, Nassima
中科院分区：
文献类型：
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作者：
Blevins, Derek;Wang, Xin-Qun;Ait-Daoud, Nassima
背景/目的托吡酯已被研究用于治疗物质使用障碍，并经常用于治疗其他冲动控制受损的疾病。我们试图确定冲动是否可以预测托吡酯治疗反应的个人与可卡因使用disorder（CUD）。MethodsIn事后分析的12周，双盲，随机，安慰剂对照试验托吡酯为CUD，我们研究了治疗反应和参与者的基线评分之间的关系巴雷特冲动量表（BIS-11）。在最初的试验中，托吡酯在6周内滴定至300毫克/天，并维持6周。所有参与者每周接受认知行为therapy.ResultsIndividuals总BIS-11评分高于中位数有11.2%以上的无可卡因天托吡酯与安慰剂（Bonferroni校正p=0.047）。自我控制中一阶因子得分高于中位数的个体（Bonferroni校正p=0.020）且处于或低于注意力中位数（Bonferroni校正p=0.022），二阶因子得分等于或低于注意力的中位数，（Bonferroni校正p=0.024）和运动冲动（Bonferroni校正p=0.046）均与托吡酯的更大改善相关。Discussion/ConclusionThe results indicate a association between higher within group impulsivity and response to topiramate for CUD.子评分结果可能表明有效性和已知的认知副作用之间存在复杂的相互作用。这一发现，特质冲动与治疗反应是一个很有前途的发现，可能有助于指导治疗CUD.Scientific SignificanceThis分析表明，一个可能的内在表型的基础上冲动，可以预测治疗反应托吡酯。(Am J Addict 2019;XX：1-6）。
Background/ObjectivesTopiramate has been studied in the treatment of substance use disorders and is often used off-label in the treatment of other disorders with impaired impulse control. We sought to determine whether impulsiveness could predict topiramate treatment response in individuals with cocaine use disorder (CUD).MethodsIn a post-hoc analysis of a 12-week, double-blind, randomized, placebo-controlled trial of topiramate for CUD, we examined the relationship between response to treatment and participants' baseline score on the Barrett Impulsiveness Scale (BIS-11). During the original trial, topiramate was titrated up to 300mg/day over 6 weeks and maintained for 6 weeks. All participants received weekly cognitive behavioral therapy.ResultsIndividuals with total BIS-11 scores above the median had 11.2% more cocaine-free days with topiramate versus placebo (Bonferroni corrected p=0.047). Individuals with first-order factor scores above the median in self-control (Bonferroni corrected p=0.020) and at or below the median in attention (Bonferroni corrected p=0.022), and second-order factor scores at or below the median in attentional (Bonferroni corrected p=0.024) and motor impulsiveness (Bonferroni corrected p=0.046) were all associated with a greater improvement with topiramate.Discussion/ConclusionThe results indicate an association between higher within-group impulsiveness and response to topiramate for CUD. The subscore findings may suggest a complex interaction between effectiveness and known cognitive side effects. The finding that trait impulsiveness is associated with treatment response is a promising discovery that may help guide treatment for CUD.Scientific SignificanceThis analysis suggests a possible endophenotype based on impulsiveness that can predict treatment response to topiramate. (Am J Addict 2019;XX:1-6).