Medication Found to Reduce Heavy Drinking

Researchers have found that topiramate, an anticonvulsant medication, can help patients who want to limit their drinking to safe levels.

February 14, 2014 — Henry R. Kranzler, M.D. and his team of researchers at Penn Medicine found that topiramate, a medication used to treat seizures, helps patients who aim to curb alcohol consumption because of the damage it causes to their bodies, their families, and the community.

The effects of the drug were significant compared to the placebo in individuals carrying a single nucleotide polymorphism known as rs2832407. A single nucleotide polymorphism is a DNA variation occurring when a single nucleotide–A,T,G or C–differs between paired chromosomes. This difference in a single nucleotide causes genetic variation which underlie differences in susceptibility to disease. Studies have shown that the single nucleotide polymorphism rs2832407 has been associated with alcohol dependence.

Researchers at Penn Medicine have found that topiramate, a medication used to prevent seizures, can help those struggling with heavy drinking to limit their drinking to safe levels.

“This study represents an important next step in understanding and treating problem drinking,” Kranzler, MD asserts. “Our study is the first we are aware of in which topiramate was evaluated as an option for patients who want to limit their drinking to safe levels, rather than stop drinking altogether.”

Approximately 14 million Americans, which is 1 in every 13 adults, abuse alcohol or are deemed alcoholics. Additionally, millions of more adults exhibit drinking habits that could potentially lead to alcohol problems. These habits include binge drinking and heavy drinking on a regular basis. Furthermore, 53% of men and women in the United States report that they have a close relative with a drinking problem. As a result, Topiramate may help people to drink at safe levels, especially those people who are struggling with heavy drinking but do not wish to abstain from alcohol completely.

Kranzler’s research team worked with 138 individuals who were randomly assigned to receive treatment with topiramate at a maximum daily dose of 200 mg or a matching placebo. Both groups received counseling to aid in the reduced drinking. Kranzler’s team hypothesized that topiramate-treated patients would be better able to abstain from alcohol. He predicted that this ability to abstain would be due to the moderation of the single nucleotide polymorphism (rs2832407).

The results showed that topiramate significantly reduced heavy drinking days and increased days of restraint from alcohol compared to placebo. During the last week of treatment, the odds of having a heavy drinking day in the placebo group was 5.33 times greater than the topiramate treatment group. Additionally, the number of patients with no heavy drinking days during the last four weeks of treatment in the topiramate group was double that of the placebo group. Finally, patients in the topiramate group reported many more abstinent days than the placebo patients.

The effect on heavy drinking days was only seen in those patients who contained the rs2832407, which was congruent with Kranzler’s hypothesis. “The moderator effect of rs2832407, if validated, would facilitate the identification of heavy drinkers who are likely to respond well to topiramate treatment and provide an important personalized treatment option,” the research team stated.

“Our hope is that the study will result in additional research focusing to help patients who have struggled with heavy drinking and the problems it causes, but who are unable or unwilling to abstain from alcohol altogether. Topiramate may help people to drink at safe levels,” Kranzler states. Furthermore, because it was found that only patients who contained the rs2832407 polymorphism were significantly effected on heavy drinking days, Kranzler hopes that this will “allow us to predict, in advance, who may benefit from treatment, thereby avoiding the unnecessary use of the medication.”

Kayleigh Makoid

Dickinson College

Sources:

Henry R. Kranzler, Jonathan Covault, Richard Feinn, Stephen Armeli, Howard Tennen, Albert J. Arias, Joel Gelernter, Timothy Pond, Cheryl Oncken, Kyle M. Kampman. Topiramate Treatment for Heavy Drinkers: Moderation by aGRIK1PolymorphismAmerican Journal of Psychiatry, 2014; DOI:10.1176/appi.ajp.2013.13081014

Perelman School of Medicine at the University of Pennsylvania. “Topiramate reduces heavy drinking among patients seeking to cut down on alcohol consumption.” ScienceDaily. ScienceDaily, 14 February 2014. <www.sciencedaily.com/releases/2014/02/140214075307.htm>.

 

About Kayleigh Makoid