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Substance Abuse and Addiction Health Center

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Seizure Drug May Treat Alcoholism

Study Shows Fewer Heavy Drinking Days for Patients Treated With Topamax

Fewer Drinks and Drinking Days continued...

Study participants were treated with up to 300 milligrams of Topamax a day or a placebo during the 14-week trial. Both groups had a weekly, 15-minute session with a health care provider designed to promote adherence to treatment.

Only 5% of the Topamax users and 2.7% of the placebo users reported attending Alcoholics Anonymous meetings during the study.

Compared with placebo treatment, treatment with Topamax was associated with an 8% greater reduction in the percentage of heavy drinking days during the trial, the researchers reported.

Researcher Bankole Johnson, MD, PhD, tells WebMD that alcoholics in the trial who took Topamax went from the equivalent of drinking a bottle and a half of wine a day to about 3 1/2 glasses of wine.

"I think that is a big difference," he says. "Most people can manage that amount of alcohol without getting into too much trouble."

The researchers reported that Topamax users had a greater rate of achieving 28 or more days of continuous nonheavy drinking during the study and 28 days of continuous abstinence.

But they were also more likely to drop out of the trials due to side effects, with 34 doing so in the Topamax group compared with just eight in the placebo group.

Half of the Topamax users experienced burning or prickling sensations in their extremities, compared with 20% of placebo-treated patients. Concentration problems, loss of appetite, and a distorted sense of taste were also more common compared with those taking placebo.

But Johnson says most of these side effects disappear over time. Some of his alcohol-dependent patients have been taking Topamax for as long as two years, and he says they will likely stay on it.

"I think we are about to see a paradigm shift in the treatment of alcohol dependence," he says. "This treatment and the other drug treatments offer people an alternative that they haven't had before."

Drugs to Stop Drinking

Addiction treatment expert Mark L. Willenbring, MD, agrees, but adds that drugs should not be seen as a replacement for today's most widely used nondrug treatments like rehab and Alcoholics Anonymous.

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