title: Cognitive changes in topiramate-treated patients with alcoholism: a 12-week prospective study in patients recently detoxified.
abstract: OBJECTIVE
  The aim of this study was to determine the 12-week cognitive changes in topiramate-treated patients recently detoxified from alcohol.
  
  
  METHODS
  Participants were inpatients with DSM-IV alcohol dependence. All of them were discharged within 14 days after the initiation of topiramate treatment. The topiramate dose range was 50-300 mg/day. The Montreal Cognitive Assessment (MoCA) was used on day 0, day 29, day 57, and day 85. Differences of the MoCA total and seven subtest scores among four time-points were compared.
  
  
  RESULTS
  Thirty-eight participants (36 men and two women) had a mean ± SD age of 43.1 ± 8.6 years old. At enrollment, they were abstinent for a mean ± SD of 11.5 ± 5.3 days. Five, one, and three patients dropped out of the study on day 29, day 57, and day 85, respectively. On day 85, the mean ± SD dose of topiramate was 253.1 ± 60.8 mg/day. Alcohol consumption decreased drastically during follow up. At each time-point, 75%-80% of the participants were continuous abstainers. The mean ± SD MoCA total, language subtest, and delayed recall subtest scores increased significantly from day 0 to day 85, from 22.0 ± 4.7 to 24.7 ± 3.4 (P < 0.01), from 1.1 ± 1.0 to 1.3 ± 1.0 (P = 0.03), and from 2.7 ± 1.7 to 4.1 ± 1.0 (P < 0.01), respectively.
  
  
  CONCLUSIONS
  Topiramate-treated patients recently detoxified from alcohol usually have an improvement of their cognitive function, especially in the language and delayed recall domains. This phenomenon may be caused by the greater influence of cognitive recovery associated with decreased drinking as compared with topiramate-induced cognitive impairment.
authors.affiliation: Department of Psychiatry, Faculty of Medicine, Chiang Mai University Chiang Mai Drug Dependence Treatment Center, Chiang Mai, Thailand.
authors.forename: Surinporn
authors.initials: S
authors.lastname: Likhitsathian
authors.forename: Pichai
authors.initials: P
authors.lastname: Saengcharnchai
authors.forename: Kanok
authors.initials: K
authors.lastname: Uttawichai
authors.forename: Jatsada
authors.initials: J
authors.lastname: Yingwiwattanapong
authors.forename: Apisak
authors.initials: A
authors.lastname: Wittayanookulluk
authors.forename: Manit
authors.initials: M
authors.lastname: Srisurapanont
mesh_terms: D000293:Adolescent; D000328:Adult; D000435:Alcoholic Intoxication / Q000628:therapy; D000437:Alcoholism / Q000188:drug therapy* / Q000523:psychology*; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000139:chemically induced / Q000523:psychology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D009483:Neuropsychological Tests; D010352:Patient Dropouts; D011446:Prospective Studies; D011597:Psychomotor Performance / Q000502:physiology; D020127:Recovery of Function; D012959:Socioeconomic Factors; D000077236:Topiramate; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D018696:Neuroprotective Agents; D000077236:Topiramate; D005632:Fructose