Topiramate as add-on therapy in non-respondent alcohol dependant patients: a 12 month follow-up study.
BACKGROUND
Topiramate is a neuromodulator drug with different action mechanisms that could be implicated in alcohol dependence. It has been studied in open and double-blind studies.


METHODS
In a group of patients (n = 64) undergoing standard treatment for alcohol dependence (according to ICD-10 criteria) with poor outcomes, a 12 month observational, prospective and multicenter study was conducted to assess the usefulness and tolerability of topiramate as addon therapy. Outcome measures were retention rate, alcohol consumption (days of drinking per month and number of Standard Drink Units [SDU] per day, and results of Alcohol Dependence Intensity Scale [ADIS]), craving and priming visual scales and serum transaminase levels.


RESULTS
In these patients, adding topiramate leads to a significant decrease (p<0.001) in all the variables studied, including those derived from the craving and priming visual scales, the ADIS as well as the number of drinks/day and SDU/day consumed, the MCV and GGT values. Mean topiramate dose was almost 200 mg/day. Only three patients dropped out due to adverse reactions.


CONCLUSIONS
Topiramate showed positive results for alcohol dependence in real clinical practice, with a significant decrease in craving-priming and dependence intensity scales, number of drinking days per month reported and transaminase levels. Topiramate seems to be a useful and well-tolerated pharmacological aid for patients with bad evolution in their alcohol dependence treatment.
Fernandez Miranda
J J
JJ
Mental Health Services, Servicios de Salud Mental de Asturias (SESPA) Asturias, Spain. miranvilla@telefonica.net
Marina González
P A
PA
Montes Pérez
M
M
Díaz González
T
T
Gutierrez Cienfuegos
E
E
Antuña Díaz
M J
MJ
Bobes García
J
J
D000328:Adult; D000427:Alcohol Deterrents / Q000378:metabolism* / Q000627:therapeutic use*; D000437:Alcoholism / Q000188:drug therapy* / Q000534:rehabilitation*; D015331:Cohort Studies; D004311:Double-Blind Method; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D005632:Fructose / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D008297:Male; D018696:Neuroprotective Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D011446:Prospective Studies; D000077236:Topiramate
D000427:Alcohol Deterrents; D018696:Neuroprotective Agents; D000077236:Topiramate; D005632:Fructose