Περίληψη:
Background: GABAergic anticonvulsants have been recommended for the
treatment of alcohol dependence and the prevention of relapse. Several
studies have demonstrated topiramate’s efficacy in improving drinking
behaviour and maintaining abstinence. The objective of the present
open-label controlled study was to assess efficacy and tolerability of
low-dose topiramate as adjunctive treatment in alcohol dependence during
the immediate post-detoxification period and during a 16-week follow-up
period after alcohol withdrawal.
Methods: 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, were monitored for 4-6 weeks immediately following
detoxification on an inpatient basis. Thereafter, both groups were
followed as outpatients at a weekly basis for another 4 months in order
to monitor their course and abstinence from alcohol.
Results: A marked improvement in depressive (p < 0.01), anxiety (p <
0.01), and obsessive-compulsive drinking symptoms (p < 0.01) was
observed over the consecutive assessments in both study groups. However,
individuals on topiramate fared better than controls (p < 0.01) during
inpatient treatment. Moreover, during the 4-month follow up period,
relapse rate was lower among patients who received topiramate (66.7%)
compared to those who received no adjunctive treatment (85.5%), (p =
0.043). Time to relapse in the topiramate augmentation group was
significantly longer compared to the control group (log rank test, p =
0.008). Thus, median duration of abstinence was 4 weeks for the
non-medicated group whereas it reached 10 weeks for the topiramate
group. No serious side effects of topiramate were recorded throughout
the study.
Conclusions: 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.
Συγγραφείς:
Paparrigopoulos, Thomas
Tzavellas, Elias
Karaiskos, Dimitris and
Kourlaba, Georgia
Liappas, Ioannis
