Topiramate for the treatment of alcohol dependence: comparison with naltrexone.
BACKGROUND
A 6-month naturalistic, randomized and open-label, trial of topiramate versus naltrexone was conducted, with assessments at enrollment and after 3 and 6 months of treatment. 182 alcohol-dependent patients who had been drinking heavily during the past month were included.


METHODS
Outcome was measured using tools that assessed alcohol intake, cravings, disability, and quality of life; changes in biomarkers of alcohol intake were also used.


RESULTS
At the 6-month evaluation, patients taking topiramate had significantly lower scores on the OCDS (all subscales), the EuropASI (medical, alcohol, family/social, and psychiatric) and the WHO/DAS (employment/social). More patients taking topiramate remained in the abstinence group and the moderate drinking without problems group.


CONCLUSIONS
Topiramate at a mean dose of 200 mg/day was better than naltrexone at a mean dose of 50 mg/day at reducing alcohol intake and cravings throughout the study.
Department of Psychiatry, University of Oviedo, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Oviedo, Spain. gerardo.florez.menendez@sergas.es
Gerardo
G
Flórez
Pilar A
PA
Saiz
Paz
P
García-Portilla
Sandra
S
Alvarez
Luis
L
Nogueiras
Julio
J
Bobes
D000428:Alcohol Drinking / Q000188:drug therapy; D000437:Alcoholism / Q000188:drug therapy*; D018683:Excitatory Amino Acid Agents / Q000627:therapeutic use*; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009271:Naltrexone / Q000627:therapeutic use*; D011788:Quality of Life; D013997:Time Factors; D000077236:Topiramate; D016896:Treatment Outcome
D018683:Excitatory Amino Acid Agents; D000077236:Topiramate; D005632:Fructose; D009271:Naltrexone