|Statement of the National Institute on Alcohol
Abuse and Alcoholism on Topiramate Clinical Trial by Johnson, et
al in 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
The National Institute on Alcohol Abuse and Alcoholism, part of
the National Institutes of Health, is the primary U.S. agency for
conducting and supporting research on the causes, consequences,
prevention, and treatment of alcohol abuse, alcoholism, and alcohol
problems and disseminates research findings to general, professional,
and academic audiences. Additional alcohol research information
and publications are available at www.niaaa.nih.gov.
The National Institutes of Health (NIH) — The Nation's
Medical Research Agency — includes 27 Institutes and
Centers and is a component of the U.S. Department of Health and
Human Services. It is the primary federal agency for conducting
and supporting basic, clinical and translational medical research,
and it investigates the causes, treatments, and cures for both
common and rare diseases. For more information about NIH and
its programs, visit www.nih.gov.