A drug used to treat epileptic seizures could help alcoholics control their addiction, a study suggests. The drug, topiramate (Topamax), proved measurably better than a placebo at helping alcoholics stay away from heavy drinking, the study authors said.
"Not only is there an effective new treatment, but there's a medication that you can take at the time of crisis. You can start immediately when you need help," said study author Bankole Johnson, MD, PhD, chairman of the University of Virginia's Department of Psychiatry and Neurobehavioral Sciences.
For treatment, many alcoholics must rely on their own willpower, often with the help of groups like Alcoholics Anonymous. But some—about 3% to 4%, Dr. Johnson estimates—try to quit drinking with the help of prescription medications.
The Study
In the new study, conducted between 2004 and 2006, Johnson and his colleagues recruited 371 alcoholics between the ages of 18 and 65. The participants, both male and female, received daily doses of topiramate or a placebo along with a brief weekly visit with a counselor.
Ortho-McNeil Janssen, the company that manufactures topiramate, funded the study.
Results
Over 14 weeks, the percentage of heavy-drinking days per week dropped from 81.9% to 43.8% among those who took topiramate and from 82% to 51.8% among those who took a placebo.
Topiramate also led to a higher rate of achieving 28 or more days of continuous non-heavy drinking and 28 or more days of continuous abstinence, the researchers said.
The drug appears to work by cutting the craving for alcohol, according to Dr. Johnson.
Drawbacks
There are side effects with topiramate, Dr. Johnson said. The drug "can make you dizzy, give you headaches and the feeling of pins and needles in your fingers. Some people have difficulty naming words, which goes away after about a week."
The drug isn't cheap-it costs about $1,000 for three months, according to Dr. Johnson. In addition, patients do not see benefits for two to four weeks.
Benefits
Still, topiramate holds promise, Dr. Johnson said. "We're talking about a drug that will be many times better than what is currently available," he said. "And it doesn't require you to go to rehab.
J.C. Garbutt, MD, professor of psychiatry at the University of North Carolina at Chapel Hill, said the research on topiramate gives doctors another option when they treat alcoholism. Since the drug is already approved for use, doctors can prescribe it immediately.
Dr. Garbutt said it's still difficult for doctors to figure out which medication to prescribe to alcoholics. But this gives you another one you can work with," he said.
Meanwhile, Dr. Johnson said, the next step is to study whether people can safely take topiramate for long periods of time.
New Pill for Problem Drinkers
The drug varenicline (Chantix), which helps smokers kick the habit, could help heavy drinkers quit their addiction, too, according to a new study. Nicotine and alcohol act on the same locations in the brain. Varenicline blocks the release of dopamine in the brain's pleasure centers. Down the road, the drug might be prescribed for addictions to everything from gambling to painkillers.
Side Effects of Chantix
The stop-smoking drug, Chantix, may cause such side effects as suicidal thoughts, drowsiness, and aggressive and erratic behavior. The Food and Drug Administration, in cooperation with the drug's manufacturer, Pfizer, is investigating the reports of these side effects. It is not yet known whether the behavior changes are related to the drug itself or to nicotine withdrawal. Other options for people trying to quit smoking are nicotine replacement and bupropion, a non-nicotine medication. All medication treatments work better when combined with counseling programs.
