May 15, 2003 -- A drug used to combat epileptic seizures may also help alcoholics curb their cravings for alcohol. New research shows the epilepsy drug Topamax helped alcoholics reduce their daily alcohol intake and increase the number of drink-free days while enrolled in an alcoholism treatment program.
Although anti-epileptic drugs have been used in a few small studies on alcohol dependency, researchers say it's the first study to look at the effects of Topamax in altering drinking behavior.
Researchers at the University of Texas Health Science Center in San Antonio randomly assigned 150 alcoholics enrolled in an alcoholism treatment program to receive either Topamax or placebo in addition to standard behavioral therapy.
After three months, people who received the drug reported drinking about three fewer drinks per day than the placebo group. Those treated with Topamax also had about 25% fewer heavy drinking days and 25% more drink-free days than the others. Blood tests also showed lower concentrations of alcohol in the Topamax group.
No serious side effects of Topamax treatment were found, and researchers increased the daily dose to up to 300 mg to achieve the best results.
Researchers say the study confirms what many experts had suspected about using anti-epileptic drugs in alcoholism treatment and should stimulate more research because few effective medications are available for this use. They say Topomax most likely works to curb cravings by inhibiting the alcohol-related release of dopamine in the reward center of the brain.
In an editorial that accompanies the study in the May 17 issue of The Lancet, Robert M. Swift of Providence VA Medical Center in Rhode Island says this study was different from most studies on alcoholism treatment because it didn't require the participants to give up drinking before starting the trial. Therefore, the study measured abstinence initiation rather than persistence.
Swift says there are still many unanswered questions about the use of prescription drugs to treat alcoholics. But the results are important because they suggest that different medications, such as anti-epileptic drugs, might be used at different stages of alcoholism treatment.
SOURCE: The Lancet, May 17, 2003.