New use for topiramate
Topiramate has shown promise for treating alcohol dependence, according to a US study.
A double-blind, randomised, placebo-controlled trial was conducted on
371 patients, aged 18–65 years, who consumed large amounts of alcohol
(more than 35 standard drinks per week for men, 28 for women). After
an assessment of drinking habit during the 28 days prior to the trial,
each participant was assigned either a titrating dose of topiramate (up
to 300mg per day) or placebo.
Participants were asked to report the number of days in which they had
drunk heavily over a 14-week period. This was defined as at least five
standard (ie, containing 14g absolute alcohol) drinks in a day for men
and at least four for women. All patients who dropped out of the study
were assumed to have reverted to their original drinking habits. In the
topiramate group, 70 of the 183 participants dropped out, compared with
44 of the 188 given placebo.
The topiramate group displayed an average decrease in heavy drinking
days from 81.91 per cent to 43.81 per cent. This compared with 82.97
per cent to 51.76 per cent for the placebo group. The topiramate group
were also more likely to complete 28 days without drinking heavily and
28 days of continuous abstinence.
The researchers concluded that topiramate was a safe and consistently
efficacious treatment of alcohol dependence, and warrants further research
(JAMA 2007;298:1641–51).
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Hospital
Pharmacist