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Tuesday, October 9, 2007

Topiramate for Treating Alcohol Dependence
A Randomized Controlled Trial
JAMA. 2007;298:1641-1651.


Hypothetically, topiramate can improve drinking outcomes among alcohol-dependent individuals by reducing alcohol's reinforcing effects through facilitation of {gamma}-aminobutyric acid function and inhibition of glutaminergic pathways in the corticomesolimbic system.

To determine if topiramate is a safe and efficacious treatment for alcohol dependence.

Treating all dropouts as relapse to baseline, topiramate was more efficacious than placebo at reducing the percentage of heavy drinking days from baseline to week 14 .

Prespecified mixed-model analysis also showed that topiramate compared with placebo decreased the percentage of heavy drinking days and all other drinking outcomes .

Adverse events that were more common with topiramate vs placebo, respectively, included paresthesia taste perversion , anorexia , and difficulty with concentration .

Topiramate is a promising treatment for alcohol dependence.

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