Battle of the Booze: New Medications
Prescription Drugs Can Help Overcome Alcohol Dependence
Alcoholics fighting their addiction have powerful new drugs to help them. Certain medications not only overcome alcoholic dependence but also the withdrawal symptoms associated with it.
Alcoholism: According to the United States National Institute on Alcohol Abuse and Alcoholism (NIAAA), alcoholism is a disease with four main features. These include (1) Craving for the drink; (2) Loss of control; (3) Physical dependence and associated withdrawal symptoms, such as nausea, sweating or shakiness after stopping drinking; and (4) Tolerance, needing more and more alcohol to get “high”. Researchers at the NIAAA have identified “unique subtypes of alcoholism based on respondents’ family history of alcoholism, age of onset of regular drinking and alcohol problems, symptom patterns of alcohol dependence and abuse, and the presence of additional substance abuse and mental disorders.” They include young adult and antisocial subtypes, functional, intermediate familial subtypes and chronic severe subtypes.
Dangers of Alcoholism: Strong scientific evidence indicates that alcoholism carries many serious dangers. They range from the risk of certain cancers to serious organ damage including damage to the liver, brain and other organs. Birth defects in pregnant women, increased risk of death from car crashes and other injuries as well as the risk of homicide and suicide are other dangers. The chronic alcoholic types have the highest rates of depression, bipolar disorder, and anxiety disorders as well as high rates of smoking, and marijuana, cocaine, and opiate dependence.
Topiramate: In a 14-week trial involving 371 male and female alcoholics, researchers at the Medical University of South Carolina along with their colleagues at the University of Virginia Health System discovered that topiramate adminstered at a dose up to 300 mg/day decreased heavy drinking. Research published in the peer-reviewed journal, Archives of Internal Medicine (June 9, 2008 edition) indicates that it also lowers the liver enzymes, plasma cholesterol, body mass index (BMI, calculated as weight in kilograms divided by height in meters squared), and systolic and diastolic blood pressure associated with heavy drinking. Unchecked, elevated levels of these biochemical and physiological changes can raise the risk of heart disease and liver damage including cirrhosis.
“Topiramate significantly decreased obsessional thoughts and compulsions about using alcohol,” according to Bankole A. Johnson and colleagues of the Topiramate for Alcoholism Advisory Board and the Topiramate for Alcoholism Study Group. It “increased subjects' psychosocial well-being, and improved some aspects of quality of life, thereby diminishing the risk of relapse and longer-term negative outcomes.” Sleep disturbances were reduced as well. Topiramate has yet to be approved by the US Food and Drug Administration for its anti-alcoholic indication.
Prescription Medications: According to the COMBINE study, alcoholics need to stick to a regimen of prescribed medications such as naltrexone and acamprosate. Supplementation with two behavioral treatments— low-intensity medical management (MM) and moderately intensive combined behavioral intervention (CBI) may be the most effective way to reduce withdrawal symptoms.
