Some alcoholics beat their addiction with the help of counseling and support groups, but for others, recovery from alcoholism is a constant struggle. Some relapse, and others never successfully stop drinking in the first place. Now a new study led by Dr. Bankole Johnson of the University of Virginia has found that a medication commonly prescribed to prevent migraines and seizures may help alcoholics lessen their alcohol intake and overcome alcohol dependence.
The 14-week study involved 371 men and women, aged 18-65, who were randomly assigned to either topiramate (or Topamax) pills or a placebo. Participants were also required to undergo weekly 15-minute counseling sessions that emphasized the importance of adhering to treatment plans. By the study's end, participants in the topiramate group reported a reduction in heavy drinking days (more than 5 drinks a day for men and more than 4 drinks a day for women) from 82% of days to 42%. Those taking the placebo only decreased heavy drinking days to 52%. 15% of the topiramate group achieved abstinence for 7 weeks or more compared to only 3% of the placebo group. However, because the researchers did not conduct a long-term study, they do not know if the participants relapsed after the study's conclusion. Although the study indicates the success of topiramate in reducing heavy drinking, the drug’s side effects were problematic. Because of tingling of the arms and legs, abnormal tastes, loss of appetite, and difficulty concentrating, about one in five participants failed to complete the study.
Despite the study's promising results, some have expressed doubt over the effectiveness of topiramate, as most participants continued to drink throughout the study. Additionally, the University of Virginia mistakenly promoted off-label use of topiramate in an early press kit. UVA spokesman Mary Jane Gore has since said, "no off-label drug use is being proposed, advocated or promoted." Joe Hulihan, Ortho-McNeil Neurologics vice president for medical affairs, says the company will not pursue FDA approval to market the drug as a treatment for alcoholism.
Other drugs are commonly used for the treatment of alcohol addiction and withdrawal, but all require the alcoholic to stop drinking beforehand and are not often helpful for people with severe alcohol dependencies. Topiramate can be taken by those who still drink and appears to effectively curb heavy drinking, making it an important step forward for those having significant difficulties breaking free from addiction. The study may appear less reliable because it was funded by Ortho-McNeil Neurologics, the company that manufactures topiramate as a preventative treatment for migraines and seizures, but we should remember that this study has demonstrated the possibility of an effective medication for heavy drinkers. With more research, we can better understand the link between alcoholism and topiramate and develop other effective medications for alcoholism.
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