The drug, Topamax, reduced alcohol cravings and withdrawal symptoms but is currently not approved by the FDA for this use. It works by altering brain signals, which reinforces the effects of abused drugs such as alcohol.
Bankole Johnson, a professor in the psychiatry and pharmacology departments of the University of Texas Health Science Center in San Antonio, conducted the study, which is reported in the August issue of Alcoholism: Clinical and Experimental Research.
The participants were 150 people aged 21-65 (107 men and 43 women) who were diagnosed with alcohol dependence. Heavy alcohol consumption is considered more than 14 standard drinks per week for men and more than seven per week for women.
Upon enrolling in the study, the women said they drank at least 21 standard drinks per week; the men reported consuming at least 35 standard drinks weekly.
A standard alcoholic drink contains approximately 12 grams of alcohol, which is equivalent to 12 fluid ounces of beer, 5 fluid ounces of wine, 3.5 fluid ounces of fortified wine (e.g., sherry or port), or 1.5 fluid ounces of liquor.
In the study participants were given either a placebo or received Topamax in doses rising from 25 milligrams to 300 milligrams per day for 12 weeks. Participants reported their drinking and alcohol cravings. Blood tests were done every three weeks to flag heavy drinking.
"Topamax was significantly more effective than placebo with regard to all self-reported drinking and craving," writes Johnson. The blood tests backed up the participants' reports, showing decreasing levels of a chemical that indicates heavy drinking.
The drug was "safe and well tolerated in alcohol-dependent individuals," writes Johnson. He says side effects occurred more frequently in the Topamax group and include mild to moderate dizziness, tingling skin, impaired memory or concentration, weight loss, and slowed psychomotor skills.
Few Other Medications
Currently, only two alcoholism drugs are available in the U.S., but recently the FDA has approved more, which are expected to be available later this year.
Topamax takes a different approach from those treatments. It targets several key sites in the brain to decrease the release of dopamine -- the "feel-good" brain chemical linked to alcohol's rewarding effects, including cravings.
One of the study's main findings was that Topamax works on people who are in the midst of their problems with alcohol.
"Most alcoholics seek help while they are still drinking and wish to quit, not when they are abstinent," says Johnson in a news release. "[Topamax] can serve to deliver treatment when it is needed most -- at the point of crisis when the patient is still drinking and looking for help to quit."
A larger study of Topamax is underway, writes Johnson.