Effectiveness of Topiramate in Treating Cocaine Dependent Individuals - 1

Inclusion Criteria: * Current DSM-IV diagnosis of cocaine dependence * Good physical health as determined by a complete physical examination, an EKG within normal limits, and laboratory screening tests within acceptable parameters * Seeking treatment for cocaine dependence * At least one positive urine drug screen for cocaine at screen or baseline prior to randomization * If female, a negative pregnancy test prior to study entry * Agrees to use an effective method of contraception for the duration of the study * Reads and writes English * Willing to participate in behavioral treatment for cocaine dependence Exclusion Criteria: * Current DSM-IV diagnosis of dependence on any psychoactive substance other than cocaine, alcohol, nicotine, caffeine, or marijuana * Physiological dependence on alcohol and requires medical detoxification * Neurological or psychiatric disorders * Any Axis 1 disorder that warrants treatment or would preclude safe participation * Organic brain disease * Dementia * Bulimia and/or anorexia nervosa * Seizure disorders or epilepsy * Any disorder which would require ongoing treatment or which would make study agent compliance difficult * History of suicide attempts and/or current suicidal ideation, as determined by the SCID, within the 30 days prior to screening * Serious medical illnesses * Mandated by the court to obtain treatment for cocaine dependence * Expected to relocate from the study area * AIDS diagnosis * HIV with a CD4 positive T cell count less than 500 mm * Any subjects on any pharmacotherapy for the treatment of AIDS or HIV will be excluded * Active syphilis that has not been treated, or refused treatment for syphilis * Severe or life-threatening adverse reactions to medications (including topiramate) in the past or during this clinical trial * Currently receiving active treatment with topiramate * Use of a drug with known potential for toxicity to a major organ system (e.g., isoniazid, methotrexate), within 30 days prior to study entry * Pregnant or breastfeeding * Concurrent regular use of psychotropics, including but not limited to antidepressants, anxiolytics, antipsychotics, anticonvulsants, and psychomotor stimulant-type medications, St. John's Wort, yohimbine, ginko biloba, horehound, or any other central nervous system active herbal preparations * Use of any opiate substitutes (e.g., methadone, levo-alpha acetyl methadol, buprenorphine), within the month prior to screening * Clinically significant test results that, in the investigator's opinion, require immediate or urgent treatment * Fever of unknown origin or neuroleptic malignant syndrome * Serious medical co-morbidity requiring medical intervention or close supervision * Received inpatient or outpatient treatment for cocaine dependence within the 4 weeks prior to study entry * Past participation in a clinical trial utilizing topiramate * Treatment with electroconvulsive therapy within the 3 months prior to study entry * Member of the same household of an individual enrolled in the present study