Topiramate: a potential new medication for treating alcoholism

  • Few medications to treat alcoholism exist.
  • New research shows that a drug called topiramate can reduce self-reported drinking.
  • This finding is corroborated by corresponding decreases in serum gamma-glutamyl transferase levels, a biological marker of heavy drinking.
  • Topiramate also appears able to reduce self-reported craving.

At present, only two drugs are currently approved for use in the United States for the treatment of alcohol dependence: the opiate antagonist naltrexone and the alcohol-aversive agent disulfiram. A third medication called acamprosate (calcium acetyl homotaurinate), used in Europe and elsewhere to prevent relapse in alcoholics, is currently under review for use by the U.S. Food and Drug Administration. A "proof-of-concept clinical trial" published in the August issue of Alcoholism: Clinical & Experimental Research examines a potential fourth medication topiramate which can act contemporaneously on more than one neuromodulator of dopamine function. Results indicate that topiramate can reduce consumption and craving in alcohol-dependent patients who are not yet abstinent.

"Few medications to treat alcoholism exist," said Bankole A. Johnson, Wurzbach Distinguished Professor in the departments of psychiatry and pharmacology at The University of Texas - Health Science Center at San Antonio, and sole author of the manuscript. "This study is the first demonstration of topiramate's efficacy for treating alcohol dependence treatment was efficacious at reducing not only drinking and craving for alcohol, but also improving abstinence and lifestyle."

"Alcohol-drinking behavior is complex, involving many neurotransmitter systems," added Raye Z. Litten, co-leader of the Medications Development Team at the National Institute on Alcohol Abuse and Alcoholism. "Dr. Johnson has postulated that targeting several key sites through the use of topiramate could result in a significant decrease


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