Importance No medication has been established as an efficacious treatment for cocaine dependence. We hypothesized that dual modulation of the mesocorticolimbic dopamine system by topiramate—a glutamate receptor antagonist and ?-aminobutyric acid receptor agonist—would result in efficacious treatment for cocaine dependence compared with placebo. Objective To determine the efficacy of topiramate vs placebo as a treatment for cocaine dependence.

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