57 research outputs found
Low-Dose Topiramate in Alcohol Dependence: A Single-Blind, Placebo-Controlled Study
Introduction:Topiramate (TOP) and anticonvulsants in general are considered safe and effective drugs for the treatment of alcohol dependence, even though TOP-induced adverse events are quite common, especially for high initial doses or if titration to 300 mg/d is too rapid. The aim of the present study was to assess the efficacy and tolerability profile of low-dose TOP for relapse prevention.
METHODS:
After detoxification, 52 patients were randomized into 2 groups as follows: 26 patients received 100 mg of TOP (oral, twice daily), titrated over 2 weeks, and 26 patients received placebo (PLA). Both groups underwent rehabilitation twice a week.
RESULTS:
After 6 weeks of treatment, compared with the PLA group, patients receiving TOP showed the following: (1) fewer drinking days (P < 0.05); (2) less daily alcohol consumption (P < 0.05); (3) more days of treatment (P < 0.05); (4) reduced levels of craving (Obsessive-Compulsive Drinking Scale) and withdrawal symptoms (Clinical Institute Withdrawal Assessment for Alcohol-Revised); and (5) improvement of anxiety, depression, and obsessive-compulsive symptom severity (Symptom Check List 90 Revised).
CONCLUSIONS:
Despite the small sample size and the short follow-up period, the present PLA-controlled study demonstrated the potential usefulness of TOP, even when administered at a dosage of 100 mg/d, for the treatment of detoxified alcohol-dependent subjects, confirming results from previous studies testing higher doses of TOP
Attentional biases in patients with alcohol dependence: influence of coexisting psychopathology
Substance use disorders and risk for treatment resistant depression: a populationâbased, nested caseâcontrol study
Repetitive transcranial magnetic stimulation of the left dorsolateral prefrontal cortex may improve symptoms of anhedonia in individuals with cocaine use disorder: A pilot study
Psaltic repertoire, authors and transcribers of Ms. Rom.- Greek 23 Anthologhion from the âDumitru StÄniloaeâ Ecumenical Library of the Metropolitan Church of Moldova and Bukovina in Iasi
Adult Separation Anxiety and TCI-R Personality Dimensions in Patients with Anxiety, Alcohol Use, and Gambling: A Preliminary Report
Background. Nowadays, adult separation anxiety disorder (ASAD) is an established diagnostic category but is little investigated in subjects with addictive behaviours. Objective. To assess the presence of ASAD among patients with addictive disorders in comparison with anxiety patients and measure the personality correlates in all these groups. Methods. 103 outpatients, meeting DSM-IV-TR criteria for anxiety disorders (38 patients), alcohol dependence (30 patients), or pathological gambling (35 patients), were assessed by the Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS) and the Adult Separation Anxiety Checklist (ASA-27) for separation anxiety and by the Temperament and Character Inventory-Revised (TCI-R) for personality characteristics. Results. ASAD is detected in 34.2% of anxiety patients, 13.3% of alcoholics, and 11.4% of gamblers. Separation anxiety scores correlate positively with harm avoidance and negatively with self-directedness in all groups; further correlations are seen among addictive patients only, that is, self-transcendence for gamblers and cooperativeness for both alcoholics and gamblers. Conclusions. The prevalence of ASAD is lower among addictive patients than in those with anxiety disorders; correlations are found between separation anxiety and specific TCI-R dimensions, with some matching across the three diagnostic groups
P. 6. a. 005 Low-dose topiramate in alcohol dependence: a randomized, double-blind, placebo-controlled trial
Low-dose topiramate in alcohol dependence: a randomized, double-blind, placebo-controlled trial
The anticonvulsivant topiramate could be useful in the treatment of
Alcohol Withdrawal Syndrome since it has the ability to suppress
glutamatergic input, to facilitate GABAA-mediated inhibitory impulse, to block sodium and calcium channels, and to facilitate
potassium conductance [1]. Several studies have demonstrated the
safety and efficacy of topiramate in promoting abstinence and
relapse prevention [2].
Purpose of the study: The aim of this randomized, doubleblind, placebo-controlled trial was to compare topiramate at low
dosage with placebo on alcohol drinking indices and craving in
detoxified alcohol dependent subjects. Psychiatric symptomatology, quality of life and clinical global improvement have also
been investigated.
Methods: 52 detoxified Alcohol Dependent (DSM-IV-TR)
outpatients (M/F 2/1, mean age 46.1±11.1; mean daily drinks
8.3±3.2; mean years of addiction 6.8±3.7) were recruited and
subsequently randomized into two groups, respectively receiving
topiramate (100 mg/die) (n = 26) or placebo (n = 26). The level
of craving for alcohol was evaluated through a 10-cm Visual Analogue Scale (VASc) and the Italian version of the Obsessive
and Compulsive Drinking Scale (OCDS). Psychiatric symptomatology was evaluated through the Symptom Check List 90 Revised
(SCL-90-R), withdrawal symptoms through the Clinical Institute
Withdrawal Assessment of Alcohol-Revised (CIWA-Ar), quality
of life through the Quality of Life Index 74 (QL-INDEX-74) and
clinical global improvement using the Clinical Global Impression
(CGI). Subjects were assessed at the beginning of the treatment
(T0) and after 30 (T1), 90 (T2) and 180 (T3) days.
Results: The survival function showed that patients treated with
topiramate remained abstinent from any alcohol amount for a
longer time with respect to placebo (Z = â2.197; p<0.05). The
improvement of alcohol drinking indices and craving scores was
significant in both groups but higher in the topiramate than in the
placebo one (OCDS: p<0.05; VASc: p<0.05). Withdrawal total
scores as measured by the CIWA-Ar were significantly reduced
in the topiramate group (F = 3.8; p<0.025) and in the placebo
group (F = 3.2; p<0.025). Significant improvements (p<0.05) for
both groups were seen at the CGI and the QL-INDEX-74. The
SCL-90-R general index of âPositive Symptom Totalâ was significantly reduced only in the topiramate group (F = 3.41, p <0.05).
The number of patients dropped-out from the study for adverse
events was not different between groups. No clinically relevant
differences between groups were seen in the mean change from
baseline for any vital signs, ECGs, haematological, or clinical
chemistry parameters.
Conclusions: Topiramate resulted to be more efficacious than
placebo for both the improvement of withdrawal symptomatology
and the reduction of relapses. Furthermore, it showed efficacy
in reducing craving, obsession and compulsion connected with
alcohol intake, the severity of global psychopathology and in
improving the quality of life. Moreover, the use of topiramate
at low dosage could increase the number of subjects remaining in
treatment, given the reduced possibility of adverse events. In conclusion, our results continue to provide evidence that topiramate is
a safe and effective treatment, which could represent an alternative
option beyond the already approved agents for the treatment of
Alcohol Dependence
Low-dose topiramate in alcohol dependence a single-blind, placebo-controlled study
Introduction: Topiramate (TOP) and anticonvulsants in general are considered safe and effective drugs for the treatment of alcohol dependence, even though TOP-induced adverse events are quite common, especially for high initial doses or if titration to 300 mg/d is too rapid. The aim of the present study was to assess the efficacy and tolerability profile of low-dose TOP for relapse prevention. Methods: After detoxification, 52 patientswere randomized into 2 groups as follows: 26 patients received 100 mg of TOP (oral, twice daily), titrated over 2 weeks, and 26 patients received placebo (PLA). Both groups underwent rehabilitation twice a week. Results: After 6 weeks of treatment, compared with the PLA group, patients receiving TOP showed the following: (1) fewer drinking days (P < 0.05); (2) less daily alcohol consumption (P < 0.05); (3) more days of treatment (P < 0.05); (4) reduced levels of craving (Obsessive-Compulsive Drinking Scale) and withdrawal symptoms (Clinical Institute Withdrawal Assessment for Alcohol-Revised); and (5) improvement of anxiety, depression, and obsessive-compulsive symptom severity (Symptom Check List 90 Revised). Conclusions: Despite the small sample size and the short follow-up period, the present PLA-controlled study demonstrated the potential usefulness of TOP, even when administered at a dosage of 100 mg/d, for the treatment of detoxified alcohol-dependent subjects, confirming results from previous studies testing higher doses of TOP
- âŠ