Statement of the National Institute on Alcohol Abuse and Alcoholism on Topiramate Clinical Trial by Johnson, et al. JAMA 10/10/07
The promising results of the topiramate treatment study reported by Johnson, et al in the October 10, 2007 issue of the Journal of the American Medical Association represent another development in ongoing efforts to expand and improve treatment options for individuals with alcohol dependence (alcoholism). Topiramate significantly reduced drinking among alcohol dependent individuals. And unlike previous studies with other medications, participants were currently drinking when they entered the study.
Three anti-alcoholism agents -- disulfiram, naltrexone (in both oral and injectable formulations), and acamprosate -- are now approved for use in the United States and many other countries. Each of these has been shown to help patients reduce drinking, avoid relapse to heavy drinking, achieve and maintain abstinence, or gain a combination of these effects. As with medications for other chronic diseases, these medications are effective for some, but not all, patients. New medications are needed to provide effective therapy to a broader spectrum of alcohol dependent individuals.
In addition to medications, other treatment approaches include professional counseling and mutual help groups. All pharmacological and non-pharmacological approaches are complementary - they share the same goals while addressing different aspects of alcohol dependence: neurobiological, psychological, and social. Expanding the range of effective treatments will maximize patient choice and outcomes, since no single approach is universally successful or appealing to patients.
Guidance regarding the use of approved medications and other tools to help patients with drinking problems is outlined in NIAAA’s Helping Patients Who Drink Too Much: A Clinician’s Guide, available on the Web at: http://pubs.niaaa.nih.gov/publications/Practitioner/CliniciansGuide2005/clinicians_guide.htm. The Guide provides tools for rapid screening, assessment and management of at-risk drinking and alcohol use disorders, including information on medications and how to provide brief behavioral support to such patients.