Treatment of alcohol dependence with low-dose topiramate: An open-label controlled study Full Text
BMC Psychiatry, 03/16/2011  Clinical Article

Paparrigopoulos T et al. – Low-dose topiramate as an adjunct to psychotherapeutic treatment is well tolerated and effective in reducing alcohol craving, as well as symptoms of depression and anxiety, present during the early phase of alcohol withdrawal. Furthermore, topiramate considerably helps to abstain from drinking during the first 16-week post-detoxification period.

• Following a 7-10 day inpatient alcohol detoxification protocol, 90 patients were assigned to receive either topiramate (up to 75 mg per day) in addition to psychotherapeutic treatment (n=30) or psychotherapy alone (n=60)
• Symptoms of depression and anxiety, as well as craving, monitored for 4-6 weeks immediately following detoxification on an inpatient basis
• Both groups followed as outpatients at weekly basis for another 4 months in order to monitor their course and abstinence from alcohol

• Marked improvement in depressive , anxiety , and obsessive-compulsive drinking symptoms observed over consecutive assessments in both study groups
• Individuals on topiramate fared better than controls (p<0.01) during inpatient treatment
• During 4-month follow up period, relapse rate lower among patients who received topiramate (66.7%) compared to those who received no adjunctive treatment (85.5%)
• Time to relapse in topiramate augmentation group significantly longer compared to control group
• Median duration of abstinence 4 weeks for non-medicated group whereas it reached 10 weeks for topiramate group
• No serious SE of topiramate recorded throughout study