Topiramate: Personalized Treatment of Alcohol Abuse

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Researchers at Penn Medicine have shown that the anticonvulsant medication, topiramate, previously shown to reduce drinking in patients committed to abstaining from alcohol, can also be helpful in treating problem drinkers whose aim is to just curb their alcohol consumption, especially in a specific group of patients.

"Our study is the first we are aware of in which topiramate was evaluated as a treatment option for patients who want to limit their drinking to safe levels, rather than stop drinking altogether,” Henry R. Kranzler, MD, professor of Psychiatry, director of Penn's Center for Studies of Addiction and lead study author, was quoted as saying.

The trial included a total of 138 heavy drinkers, about half of whom received 12 weeks of treatment with topiramate. Results showed that the patients who received topiramate had fewer heavy drinking days than those in the placebo group. By the end of treatment, the odds of experiencing a heavy drinking day in the placebo group was five times more than that of the topiramate group; and the number of patients who experienced no heavy drinking days on the last four weeks of treatment in the topiramate group was more than double that of the placebo group.

The study also has important implications for the personalized treatment of heavy drinking. Analysis showed that only individuals with a specific genotype found in 40 percent of European-Americans benefitted from treatment with topiramate.

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