New drug treatment set to change ways of alcoholism

An 18-week experimental study, published in Alcohol Clinical & Experimental Research, examining the effects of the drug, topiramate, on tobacco smoking and alcohol use found no differences between groups treated with topiramate and those receiving placebo treatment in the last 4 weeks of treatment.

However, the authors reported a lower average percentage of heavy drinking days and drinks per day in participants who were treated with the highest tested dose of the substance compared to the other groups across the assessments conducted after the target quit date.

Topiramate is a prescription medication originally developed as an antiepileptic drug to treat seizures. It is also commonly used for migraine prevention and, in combination with other drugs, for weight management.

The drug works by modulating multiple neurotransmitter systems, including enhancing the activity of the inhibitory neurotransmitter GABA and reducing the excitatory activity of the neurotransmitter glutamate. Because of these mechanisms, topiramate can reduce the heightened excitability of neurons in the brain.

The medication is sometimes used off-label for conditions such as bipolar disorder, alcohol use disorder, and binge eating disorder.

Study author Jason D. Robinson and his colleagues wanted to explore whether topiramate would be effective in treating individuals with alcohol use disorder and tobacco use disorder.

More specifically, they wanted to see whether 250 mg and 125 mg of topiramate per day would result in reducing heavy drinking and cigarette smoking behaviors in individuals motivated to try to quit both substances.

The study authors hypothesized that the higher dose would be more effective than the lower dose.

“While the primary analyses did not find evidence that topiramate decreases drinking and smoking behavior, likely influenced by a high attrition rate and poor medication adherence, exploratory repeated measures analyses suggest that topiramate 250 mg reduces drinking behavior and that both the 125 mg and 250 mg doses reduce smoking behavior,” the study authors concluded.