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Drug Helps Heavy Drinkers Abate

MedicationA multisite clinical trial demonstrated that the drug topiramate, is a safe and effective medication to help heavy drinkers curb their alcohol dependence.

Researchers believe prescription of the medication should be accompanied by brief counseling thereby providing a treatment regimen that can be delivered by non-specialists in a variety of community settings.

“Topiramate has emerged as a promising treatment for people with alcohol dependence,” says the lead author, Professor Bankole Johnson, chairman of the University of Virginia Department of Psychiatry and Neurobehavioral Sciences.

“Our finding in this national study was that topiramate is a safe and highly efficacious medicine that can be paired with a 15-minute brief intervention by health practitioners who are not addiction specialists. Community practice settings in the United States and in many parts of the world, therefore, have the potential to use this combination treatment.”

Greater access to treatment with an effective medicine that can be delivered with a brief intervention by non-specialists should lead to success for many people battling the alcoholism disease, Prof. Johnson noted. “One of our next steps is to directly study topiramate’s efficacy in treating alcoholics within community practice settings.”

During the 14-week study published in the October 10 issue of the Journal of the American Medical Association, 371 male and female alcoholics, all of whom were drinking heavily at the time of entering the trial, were randomly selected to take topiramate (up to 300 mg/day) or placebo.

All of them had a weekly 15-minute intervention with a trained nurse to enhance adherence to the medication and treatment regimen. Topiramate was previously approved by the Food and Drug Administration for seizures and migraine headaches and is manufactured by Ortho-McNeil Neurologics, Inc. Topiramate is not currently approved for the treatment of alcohol dependence.

Researchers approached the results as conservatively as possible, counting all dropouts or people who missed appointments as subjects who relapsed to their baseline drinking level. Even so, topiramate lowered the percentage of heavy drinking days (the number of days in which men and women consumed ≥5 drinks/day and ≥4 drinks/day, respectively, divided by the number of study days) by a mean of 8.44 percent more than placebo.

The topiramate group had a reduction from 82 percent to a mean of 44 percent heavy drinking days during the 14 weeks, while the placebo group had a reduction from 82 ercentr to a mean of 52 percent heavy drinking days.

In a second analysis that tested the study hypothesis for all randomized participants who took at least one study medication dose and had at least one double-blind site visit, topiramate was much more efficacious than placebo, lowering the percentage of heavy drinking days by a mean of 16.19 percent more than placebo.

Additionally, for all secondary measures of self-reported drinking and the laboratory marker for drinking, gamma-glutamyltransferase in plasma, topiramate was more efficacious than placebo, according to both sets of analysis.

Importantly, both of these sets of analysis demonstrate the consistency and robustness of topiramate’s efficacy over placebo in treating alcohol dependence. Furthermore, this trial demonstrates that alcoholics who are drinking severely can begin to receive a safe and efficacious medicine immediately without having to undergo detoxification or stop drinking first—an important paradigm shift.

Ortho-McNeil Janssen Scientific Affairs provided the study medication, topiramate, and funding for this study.

Source: University of Virginia Health System

Drug Helps Heavy Drinkers Abate

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2018). Drug Helps Heavy Drinkers Abate. Psych Central. Retrieved on March 21, 2019, from
Scientifically Reviewed
Last updated: 8 Aug 2018
Last reviewed: By a member of our scientific advisory board on 8 Aug 2018
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