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Topiramate Shows Promise As Treatment For Alcohol Dependence

Topiramate is a drug that decreases cellular release of dopamine (one of the feel-good neurotransmitters) in the midbrain, and also antagonizes several other receptors and thus may minimize alcohol’s rewarding effects. This study investigated its effectiveness as a treatment for alcohol dependence. Study participants comprised 150 individuals (107 males, 43 females) seeking treatment for alcohol dependence. Seventy-five received topiramate (an escalating dose of 25 to 300 mg per day), and 75 received a placebo in conjunction with standardized medication. After 12 weeks of treatment, researchers measured drinks per day, drinks per drinking day, heavy drinking days, days abstinent, levels of a tell-tale clue evident in blood tests (plasma gamma-glutamyl transferase), and self-reported craving.

Study participants who received topiramate had fewer drinks per day, fewer drinks per drinking day, fewer heavy drinking days, more days of abstinence, decreased levels of plasma gamma-glutamyl transferase, and comparatively reduced craving. In short, topiramate appears to be more effective than placebo in reducing drinking and encouraging abstinence among alcohol dependent individuals who are undergoing treatment.

(Johnson, BA, Ait-Daoud, N, Bowden, CL, DiClemente, CC, Roache, JD, Lawson, K, Javors, MA, Ma, JZ: Oral topiramate for treatment of alcohol dependence: A randomised controlled trial. The Lancet 361:1677-1685, 2003.)

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