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Medications proven effective treatment for alcoholics

Individuals 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 dependent individuals.
“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 disease.
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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