Do you or a loved one suffer from alcohol dependence or abuse ? If so, you know how difficult treatment can be. There may be some hope for those who struggle from alcohol dependence. There may be a medication that helps reduce the amount of alcohol consumed and increase the length of abstinence.
In a study published in the October 2007 Journal of the American Medical Association , researchers compared the amount of alcohol consumed in patients who took the medication topiramate (Topamax) and those that took a placebo (an inactive substance resembling a medication). All patients had weekly Brief Behavioral Compliance Enhancement Treatment (BBCET) intervention to emphasize medication adherence. Researchers found that patients taking the medication consumed less alcohol and had more days abstinent.
About the Study
Researchers enrolled 371 patients aged 18-65 years with alcohol dependence into the study. Half of the patients took topiramate (Topamax) starting at 25 mg once daily and increased to 300 mg/day in two divided doses for 14 weeks. The other half took a placebo. Heavy drinking days were defined as ≥5 standard drinks for men and ≥4 for women per day. All patients drank ≥28 (for women) or ≥35 (for men) standard drinks per week at baseline (the start of the study). Drinking reduction was assessed weekly by a self-reported patient diary and a blood test measured at weeks zero, four, eight, 12, and 14.
After 14 weeks, more patients who took topiramate experienced a decreased amount of alcohol consumed daily and a decreased number of heavy drinking days. The most hopeful piece of the study is that 15% of patients achieved ≥28 days of continuous abstinence with topiramate vs. 3.2% with placebo, and 30% achieved ≥28 days of continuous nonheavy drinking.
How Does This Affect You?
This study suggests that topiramate, a medication commonly used in seizure disorders, may help reduce the amount of alcohol consumed by alcohol-dependent people and contribute to prolonging abstinence. There were many side effects in the group who took topiramate, including paresthesias (a sensation of pricking, tingling, or creeping on the skin), taste perversion, loss of appetite, difficulty with concentration or attention, nervousness, dizziness, and pruritis . There are also other treatments available including other medications (acamprosate or disulfiram) and psychosocial support programs. Talk to your doctor about which treatment is best for you.
The poor health and social effects of excessive alcohol use are many. Breaking alcohol dependency is difficult and requires support from friends and family. Continuing abstinence is one of the most difficult steps. If topiramate can reduce the amount of alcohol consumed, it should also improve general health. It is not clear why this medication helps, but it does offer hope for a devastating disease.
- Reviewer: Larissa Lucas, MD
- Review Date: 11/2007 -