Topiramate Reduces Heavy Drinking and Symptoms of Alcoholism

CHARLOTTESVILLE, Va -- June 9, 2008 -- Addiction experts reported the results of a clinical trial showing that topiramate is an effective therapeutic agent that not only decreases heavy drinking but also diminishes the physical and psychosocial harm caused by alcohol dependence.

Study results of the nationwide 14-week trial involving 371 diagnosed male and female alcoholics are published in the June 9 issue of the Archives of Internal Medicine. The study indicates that topiramate was more efficacious compared with placebo in decreasing body mass index and all liver enzymes, including the log plasma gamma-glutamyltransferase ratio.

Topiramate was considerably more efficacious than placebo in reducing both systolic and diastolic blood pressure by a mean difference of 9.70 and 6.74 mm Hg, respectively. Topiramate also significantly lowered plasma cholesterol levels by an average of 16.4 mg/dL compared with a reduction of 5.7 mg/dL with placebo. Notably, these combined effects suggest that topiramate may decrease the risk of heart disease in alcohol-dependent individuals.

"Many alcoholics have hypertension, and some receive antihypertensive medication, which can complicate their treatment for alcoholism," explains lead author Bankole Johnson, DSc, MD, PhD, MP, University of Virginia Department of Psychiatry and Neurobehavioral Sciences, Charlottesville, Virginia. "Because topiramate can reduce drinking substantially and [can] decrease blood pressure significantly, this allows 1 medication to be given instead of several."

By decreasing liver enzymes and cholesterol levels, topiramate may also reduce the risk of fatty liver disease, which leads to cirrhosis, which is a common consequence to end-stage liver disease leading to death in alcoholics.

Additionally, topiramate significantly contributed to a decline in obsessive thoughts and compulsions about using alcohol. Topiramate also had greater quality-of-life improvement compared with placebo in general activities, leisure activities, and household duties, as well as a reduction in sleep disturbances.

The Food and Drug Administration has approved topiramate for seizures and migraine headaches, but it is not currently approved for treating alcohol dependence.

"What we've found is that topiramate treats the alcohol addiction, not just the 'symptom' of drinking," said Dr. Johnson.


SOURCE: University of Virginia Health System