Topamax Clinical question

[CaliCPhT]

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OK, so I just heard that Topamax (topiramate) is being used off label for smoking cessation. Can anyone tell me how this is supposed to work?

Thanks!

 

[WVUPharm2007]

If I had to guess, I'd say the secondary pharmacology of quisqualate receptor antagonism likely plays a role...I think it an nicotinic receptors have something to do with each other.

I guess....I could be wrong...actually, I probably am....

 

[SpirivaSunrise]

OK, so I just heard that Topamax (topiramate) is being used off label for smoking cessation. Can anyone tell me how this is supposed to work?

Thanks!

Did a quick search on IPA...do you have access to Khazaal Y, Cornuz J, Bilancioni R, Zullino DF. Topiramate for smoking cessation. Psychiatry Clin Neurosci. 2006 Jun;60(3):384-8. ?

Here's the intro:

Recent research on addiction has increasingly focused on glutamate. Whereas NMDA (N-methyl-D-aspartate) receptors seem to be involved in the induction, AMPA receptors may mediate the expression of established addiction. For example, AMPA has been found to reinstate drug seeking and AMPAR (AMPA receptors) antagonists to block the reinstatement. Topiramate has multiple mechanisms of action, including blockade of the AMPA/kainate subtype of glutamate receptor, which is, until now, unique among the marketed drugs. Diverse reports have recently raised its interest in the treatment of addictions. The objective of the present pilot study was to explore the efficiency of topiramate in smoking cessation.

 

[WVUPharm2007]

Haha, I was right.

 

[Epic]

I'll spoon feed you just once.

Basis of smoking cessation is to stimulate nicotinic acetylycholine receptors in the CNS to stimulate Mesolimibic Dopaminergic response.. the reward center or the brain.

Topamax' main site of action however is not the dopaminergic rather GABA stimulation. But it's not fully elucidated how Topmax aids in smoke cessation. Here are hypothesis.

Topamax can decrease urge for alcohol consumption which is associated with smoking. Scientists also believe Topamax has dopaminergic acitivities..

 

[WVUPharm2007]

I'll spoon feed you just once.

Basis of smoking cessation is to stimulate nicotinic acetylycholine receptors in the CNS to stimulate Mesolimibic Dopaminergic response.. the reward center or the brain.

Topamax' main site of action however is not the dopaminergic rather GABA stimulation. But it's not fully elucidated how Topmax aids in smoke cessation. Here are hypothesis.

Topamax can decrease urge for alcohol consumption which is associated with smoking. Scientists also believe Topamax has dopaminergic acitivities..

Mr. posts 5 minutes too late in the hizzy.

 

[Epic]

Mr. posts 5 minutes too late in the hizzy.

no one mentioned mesolimbic dopamine... that's the key you foo!

 

[WVUPharm2007]

You mean glutamate in the extended amygdala...which then works on the reinforcement center of the nucleus accumbens? We ain't talking about rewards, we're talking about conditioning...or something....

Word.

 

[Epic]

Nicotine addiction is most strongly associated with Mesolimbic Dopaminergic stimulation through Nicotine receptors. The psychological addiction..not sure which receptors are associated with it.