Oral Topiramate Reduces the Consequences of Drinking and Improves theQuality of Life of Alcohol-Dependent Individuals: A Randomized Controlled Trial
BACKGROUND Topiramate, a fructopyranose derivative, was superior to placebo at improving the drinking outcomes of alcohol-dependent individuals. OBJECTIVES To determine whether topiramate, compared with placebo, improves psychosocial functioning in alcohol-dependent individuals and to discover how t...
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Veröffentlicht in: | Archives of general psychiatry 2004-09, Vol.61 (9), p.905-912 |
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Sprache: | eng |
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Zusammenfassung: | BACKGROUND Topiramate, a fructopyranose derivative, was superior to placebo at
improving the drinking outcomes of alcohol-dependent individuals. OBJECTIVES To determine whether topiramate, compared with placebo, improves psychosocial
functioning in alcohol-dependent individuals and to discover how this improvement
is related to heavy drinking behavior. DESIGN Double-blind, randomized, controlled, 12-week clinical trial comparing
topiramate vs placebo for treating alcohol dependence (1998-2001). PARTICIPANTS One hundred fifty alcohol-dependent individuals, diagnosed using the DSM-IV. INTERVENTIONS Seventy-five participants received topiramate (escalating dose of 25
mg/d to 300 mg/d), and 75 had placebo and weekly standardized medication compliance
management. MAIN OUTCOME MEASURES Three elements of psychosocial functioning were measured: clinical ratings
of overall well-being and alcohol-dependence severity, quality of life, and
harmful drinking consequences. Overall well-being and dependence severity
and quality of life were analyzed as binary responses with a generalized estimating
equation approach; harmful drinking consequences were analyzed as a continuous
response using a mixed-effects, repeated-measures model. RESULTS Averaged over the course of double-blind treatment, topiramate, compared
with placebo, improved the odds of overall well-being (odds ratio [OR] = 2.17;
95% confidence interval [CI], 1.16-2.60; P = .01);
reported abstinence and not seeking alcohol (OR = 2.63; 95% CI, 1.52-4.53; P = .001); overall life satisfaction (OR = 2.28; 95% CI,
1.21-4.29; P = .01); and reduced harmful drinking
consequences (OR = –0.07; 95% CI, –0.12 to –0.02, P = .01). There was a significant shift from higher to
lower drinking quartiles on percentage of heavy drinking days, which was associated
with improvements on all measures of psychosocial functioning. CONCLUSIONS As an adjunct to medication compliance enhancement treatment, topiramate
(up to 300 mg/d) was superior to placebo at not only improving drinking outcomes
but increasing overall well-being and quality of life and lessening dependence
severity and its harmful consequences.Arch Gen Psychiatry. 2004;61:905-912--> |
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ISSN: | 0003-990X 1538-3636 |
DOI: | 10.1001/archpsyc.61.9.905 |