Using topiramate or naltrexone for the treatment of alcohol-dependent patients.
BACKGROUND
To compare topiramate versus naltrexone in the treatment of alcohol dependence.


METHODS
A 6-month naturalistic, randomized and open-label, trial of topiramate versus naltrexone, with assessments at enrollment and after 3 and 6 months of treatment. The setting was an outpatient alcohol clinic. One hundred and two alcohol-dependent patients who had been drinking heavily during the past month were included. Two randomized groups were created. In one, naltrexone was used as the therapeutic agent and, in the other, topiramate was chosen as the therapeutic agent. Both groups received psychological relapse prevention therapy. Outcome was measured using tools that assessed alcohol intake, cravings, disability, and quality of life; changes in biomarkers of alcohol intake were also used. With all the data, a secondary composite measure was created in order to assess each patient's global alcohol intake and its consequences.


RESULTS
Both groups showed substantial reduction in their drinking. Naltrexone patients had higher nicotine consumption throughout the study. Topiramate was better at reducing alcohol-related cravings throughout the study. Both treatments had a similar mean cost throughout the study.


CONCLUSIONS
Both topiramate and naltrexone were efficacious in the treatment of alcohol dependence, and the treatment costs were similar. There is a trend for topiramate to be superior to naltrexone on critical measures of drinking; however, the study did not have adequate statistical power to establish this fact.
Flórez
Gerardo
G
Unidad Asistencial As Burgas, Ourense, Spain. gerardof@mundo-r.com
García-Portilla
Paz
P
Alvarez
Sandra
S
Saiz
Pilar A
PA
Nogueiras
Luis
L
Bobes
Julio
J
D000328:Adult; D000437:Alcoholism / Q000188:drug therapy*; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D011581:Psychological Tests; D012720:Severity of Illness Index; D000077236:Topiramate
D009292:Narcotic Antagonists; D018696:Neuroprotective Agents; D000077236:Topiramate; D005632:Fructose; D009271:Naltrexone