Rx Helps Heavy Drinkers Drink Less

Topiramate reduces drinking in heavy drinkers with certain gene variation

/ Author:  / Reviewed by: Robert Carlson, M.D Beth Bolt, RPh

(RxWiki News) For heavy drinkers, abstaining from alcohol is a tough goal. Topiramate, a new drug, may reduce heavy drinking in people with a certain gene variation associated with alcohol dependence.

Over 23 percent of people in the U.S. over age 12 have had more than five drinks on one occasion in the last month, and 6.7 percent report doing this at least five days a month. Heavy drinkers can sometimes get help from medications to reduce their drinking.

Topiramate (brand name Topamax) has been shown to reduce the number of heavy drinking days, and a research group recently conducted a study to see if it would reduce the amount that heavy drinkers consumed as well. The researchers found topiramate reduced heavy drinking in people with a certain gene variation associated with alcohol dependence.

"Seek help for problems with heavy drinking."

Henry R. Kranzler, MD from the University of Pennsylvania led the team of researchers who conducted this research.

A total of 138 people ages 18 to 65 were included in the study. The men drank an average of 24 or more drinks a week and the women drank 18 or more drinks a week. The study subjects were divided into two groups: one group took 200 mg topiramate, and the other group took a fake placebo pill for about 11 weeks.

All patients were counseled to decrease their drinking and to increase the number of days they did not drink at all. Men were counseled to try to drink no more than three drinks a day or 12 drinks a week. Women were advised to drink no more than two drinks a day or eight drinks per week.

Breath analysis for alcohol, questionnaires about drinking and blood tests were used to determine patients' drinking during the study. Gene typing for the alcohol-related gene variation was done on blood.

The researchers saw a greater decrease in the number of heavy drinking days per week in the group taking topiramate, compared to the group who took placebo pills. In the topiramate group, heavy drinking decreased even more as the study continued.

At the end of the study, the chances of someone drinking heavily in the placebo group was 5.33 times higher than the topiramate group. Patients in the topiramate group had more days with no heavy drinking in the last four weeks than the placebo group, with 35.8 percent of topiramate patients compared to 16.9 percent of those in the placebo group.

When Dr. Kanzler and his team looked at the gene types in the people in the study, they found that only those with a certain type of gene variation had a significant decrease in heavy drinking days and an increase in the number of days with no drinking from taking topiramate.

Because the gene variation associated with the effectiveness of topiramate was present in Americans of European descent, the researchers concluded that the study should also be done in other populations of people. Dr. Kanzler predicted that this study would help design medication treatment for heavy drinking based on people's gene types.

Some reactions were reported by the people in the topiramate group. These included loss of weight and appetite, change in taste, difficulty with concentration and memory and numbness and tingling.

This study appeared in the April issue of the American Journal of Psychiatry.

Funding for this study was provided by the National Institutes of Health and the U.S. Department of Veterans Affairs.

Dr. Kanzler disclosed serving as a consultant to Roche, Alkermes, Lilly, Pfizer and Lundbeck, as well as professional membership in an organization supported by Pfizer, Lilly, Abbott and Lundbeck.

Review Date: 
February 15, 2014
Last Updated:
February 17, 2014