NIH-funded study finds that gabapentin may treat alcohol dependence
Promising results from a randomized, controlled clinical trial of the medication
The generic anticonvulsant medication gabapentin shows promise as an effective treatment for alcohol dependence, based on the results of a 150-patient clinical trial of the medication. Conducted by scientists supported by the National Institute on Alcohol Abuse and Alcoholism (NIAAA), part of the National Institutes of Health, the study found that alcohol dependent patients using gabapentin were more likely to stop drinking or refrain from heavy drinking than those taking placebo. Gabapentin is already widely prescribed to treat pain conditions and epilepsy.
“Gabapentin adds to the list of existing medications that have shown promise in treating alcohol dependence,” said Kenneth R. Warren, Ph.D., acting director of the NIAAA. “We will continue to pursue research to expand the menu of treatment options available for alcoholism in the hopes of reaching more people.”
A report of the study, led by Barbara J. Mason, Ph.D., of The Scripps Research Institute (TSRI) in La Jolla, Calif., appears in the Nov. 4, 2013 edition of JAMA Internal Medicine.
Dr. Mason and her colleagues randomly assigned alcohol dependent patients to receive a moderate or high dose of gabapentin (900 milligrams or 1,800 milligrams) or a placebo. Over the 12-week treatment, patients receiving the 1,800-milligram dose were twice as likely to refrain from heavy drinking (45 percent vs. 23 percent) and four times as likely to stop drinking altogether (17 percent vs. 4 percent), compared to placebo. Participants receiving gabapentin also reported improved sleep and mood and fewer alcohol cravings. The medication appeared to be well tolerated with few side effects.
Participants who received the 900-milligram dose of gabapentin saw similar but less dramatic improvements in their drinking levels, sleep, mood, and cravings when compared to the 1,800-milligram dose.
“The results of the study on gabapentin showed similar or greater positive outcomes when compared to existing FDA [U.S. Food and Drug Administration]-approved treatments for alcohol dependence,” said Dr. Mason, Pearson Family Professor and co-director of the Pearson Center for Alcoholism and Addiction Research at TSRI, who led the new research. “Plus, it’s the only medication shown to improve sleep and mood in people who are quitting or reducing their drinking, and it’s already widely used in primary care—that’s an appealing combination.”
Alcohol use disorders affect about 18 million people in the United States and have an estimated societal cost of $225 billion each year, primarily from lost productivity, but also from health care and property damage costs. Currently, three medications are approved by the FDA for treating alcohol dependence: disulfram, an older drug that blocks the metabolism of alcohol and causes nausea; acamprosate, which helps support abstinence and can ease symptoms of withdrawal; and naltrexone, which can help people reduce heavy drinking.
Reference
Mason BJ, Quello S, Goodell V, Shadan F, Kyle M, Begovic A. Gabapentin Treatment for Alcohol Dependence: A Randomized Clinical Trial. JAMA Intern Med. 2013 Nov 4. [Epub ahead of print]