AN OPEN LABEL COMPARISON OF EFFICACY OF LOW DOSE TOPIRAMATE WITH NALTREXONE IN THE TREATMENT OF ALCOHOL DEPENDENCE
Background:GABAergic anticonvulsants have been recommended for the treatment of alcohol dependence and the prevention of relapse. Topiramate’s efficacy in improving drinking behaviourand maintaining abstinence has been demonstrated in western studies.
Aim: The aim of the study was to assess efficacy and tolerability of low-dose Topiramate as relapse prevention agent in alcoholism in Nepalese population.
Method:Following an inpatient alcohol detoxification, 37 patients taking Topiramate 100 mg and 41 patients taking Naltrexone 50 mg were followed up as outpatients at a 1, 4, 8 and 12 weeksin order to monitor their course and abstinence from alcohol.
Results: At the end of 12 weeks follow up, Topiramate is as good as Naltrexone in terms of maintaining abstinence (27% vs 31.7%, p=0.651) and reducing the daily alcohol intake. Topiramate is better than Naltrexone in decreasing craving (OCDS Score) at 12 wks (p=0.015). The Readiness to Change Score at beginning is positively correlated with alcohol abstinence at 12 weeks (p=<0.001). Two of the 37 Topiramate group dropped out because of side effects.
Conclusion: Low dose Topiramate is equally efficacious to Naltrexone in reducing alcohol craving and maintaining abstinence. However the findings need to be confirmed with other controlled studies.
Author's Name: Dr. Kedar Marahatta