Medication improves alcoholics' quality of life

21 june 2008--The medication topiramate may not only improve drinking problems in people with alcohol dependence, but boost their quality of life as well, according to a new study.
Topiramate (Topamax) is an anti-seizure drug that has also been shown to reduce drinking in alcoholics -- possibly due to it effects on certain brain chemicals thought to be involved in alcohol dependence.
Whether treatment with the drug can also improve alcoholics' physical and mental well-being, however, has been unclear.
In the present study, Dr. Bankole A. Johnson, from the University of Virginia in Charlottesville, and colleagues addressed this question by assessing 371 patients who were randomly assigned to receive topiramate or placebo tablets daily for 14 weeks.
All of the patients participated in a weekly program designed to enhance treatment adherence.
Johnson's team found that, compared with placebo patients, those on topiramate saw a greater improvement in their weight, liver function, cholesterol levels and blood pressure -- effects, the researchers note, that could potentially cut the patients' long-term risks of cirrhosis and heart disease.
Topiramate therapy was also associated with a drop in alcohol-related obsessions and compulsions, and with improvements in psychological well-being and quality of life, the researchers report in the Archives of Internal Medicine.
Such improvements in overall well-being, they point out, could potentially reduce the risk of alcoholic relapse.
The drug did have side effects in some patients -- most commonly tingling and numbness, taste alteration, appetite loss and difficulty concentrating.
Still, the overall improvements in physical and mental well-being are promising, Johnson's team concludes.
"Our findings," they write, "demonstrate that topiramate appears to be a generally effective treatment for alcohol dependence because it improves not only the 'symptom' of drinking but also its physical and psychosocial (consequences)."
SOURCE: Archives of Internal Medicine, June 9, 2008.

Topiramate Reduces Consumption in Alcohol Dependence

Topiramate reduces the number of heavy-drinking days and other measures of drinking, according to a manufacturer-sponsored trial published in JAMA.
Some 370 patients with alcohol dependence were randomized to topiramate or placebo for 14 weeks. Patients, who were current drinkers at enrollment, received a brief weekly psychosocial intervention designed to enhance compliance and were assessed weekly on measures of drinking, including frequency and quantity.
Topiramate was more effective than placebo in reducing the percentage of heavy-drinking days, in reducing self-reported and laboratory-confirmed drinking, and in increasing the likelihood of achieving 28 days' continuous abstinence.
An editorialist writes that, along with other studies, the research provides "strong support that ... combining medication with brief behavioral support is an effective alternative to group-based counseling." He urges "all physicians to begin to see alcohol dependence as a disorder they can and should treat, and treat effectively."