Treating Alcoholism With Topiramate

TopamaxThe anticonvulsant agent topiramate (Topamax drug, Ortho-McNeil) might also be a promising therapy for alcohol dependence, according to findings from a 14-week study involving 371 adults.

The Topiramate for Alcoholism Study Group reported that generic topiramate, up to 300 mg/day, reduced the percentage of heavy drinking days from a mean of 81.91% to 43.81%; the reduction for plai cebo subjects ranged from 81.97% to 51.76%.

Participants in the topiramate group also reported fewer days of heavy drinking. Compared with the patients receiving placebo, the generic topiramate group also had lower plasma gamma glutamyl-transferase (GGT), a liver enzyme, and were more likely to go 28 or more days without heavy drinking and have 28 or more days of abstinence.

Because significant differences between the two groups emerged as early as the second week and no later than the fourth week, the researchers suggest that a smaller ceiling dose might be effective. If so, that could enhance topiramate’s utility, because there was a trend toward more frequent adverse events with escalating doses.

(Source: JAMA 2007;298:1641-1651.)