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Medications proven effective
treatment for alcoholics
who experience the physical, mental and social symptoms
associated with alcohol dependence are offered hope through the results
of two recent studies by MUSC researchers.
In separate investigations, researchers found favorable results for a
medication to help heavy drinkers who are trying to modify their
consumption, as well as a medication to reduce alcohol withdrawal
symptoms and prevent relapse.
In a landmark study, MUSC researchers, working with investigators at
the University of Virginia Health System and elsewhere, have found that
topiramate, an anticonvulsant, not only decreases heavy drinking but
also lowers all liver enzymes, plasma cholesterol, body mass index
(BMI), and systolic and diastolic blood pressure—all of which tend to
increase with heavy drinking and pose such serious health risks as
heart disease and cirrhosis. Notably, these combined effects suggest
that topiramate may decrease the risk of heart disease in alcohol
“These findings add growing data indicating that heavy drinkers who
modify their drinking with the help of medication and supportive
counseling may see an improvement in health and wellbeing, as well as a
potential reduction of risk for the develop-ment of heart and liver
diseases,” said Ray-mond Anton, M.D., Distinguished Univer-sity
Professor who led the studies. “This shows that treatment of alcoholism
has potential health benefits beyond the immediate behavioral and
emotional improvement caused by a reduction in drinking.”
By decreasing liver enzymes and cholesterol levels, topiramate also may
reduce the risk of fatty liver disease, which can lead to cirrhosis, a
common consequence of alcoholism that can be fatal in end-stage liver
Additionally, topiramate significantly contributed to a decline in
obsessive thoughts and compulsions, which are components of alcohol
craving; and also had a greater improvement in their “overall quality
of life,” specifically, reduction in sleep disturbance and a general
improvement in enjoyment of leisure activities and household duties.
The Food and Drug Administration has approved topiramate for seizures
and migraine headaches, but it is not currently approved for treating
alcohol depen-dence. Ortho-McNeil Neurologics Inc., manu-factures
topiramate and provided study funding.
Results from the nationwide 14-week trial that involved 371 male and
female diagnosed alcoholics were published in the June 9 issue of the
Archives of Internal Medicine.
Anton also presented initial results from a separate investigation of a
14-week double-blind, placebo-controlled study utilizing the Prometa
alcoholism treatment program, developed by Hythiam Inc., at the 2008
Research Society on Alcoholism (RSA) conference in Washington D.C.
Anton suggested that alcohol dependence programs are few in number and
not very effective, which is particularly true for individuals who
experience alcohol withdrawal symptoms. Prometa, a combination of
generic medications, reduced cravings and alcohol-withdrawal symptoms,
promoted abstinence, and improved mood and sleep only in those who had
symptoms of alcohol withdrawal. Although Prometa protocol has been
marketed nationally, this was the first scientific study examining its
use in individuals with alcohol dependence.
At the time of the RSA presentation, the data presented covered the
initial six-week active treatment phase of the 14-week study. While
these are initial findings, additional evaluation of the full 14-week
study data continues. Anton also plans to release specifics from this
study in a peer-reviewed publication.
Meanwhile, MUSC has an ongoing clinical trial program studying new
medications for the treatment of alcohol use disorders. For more
information call 792-2727.
Friday, July 25, 2008
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