[Topiramate treatment for decreasing alcohol consumption in alcoholics: a comparative study of responders and nonresponders]

The present study investigated the effectiveness of topiramate (TPM) treatment for decreasing alcohol consumption in alcoholics.

Alcoholics of outpatients, relapsed repeatedly, were included in this study. The study was conducted over 24 weeks. Subject characteristics (e.g., gender) and medical variables (e.g., age of onset) were recorded. Autistic features were determined using the Autism - Spectrum Quotient (>or=27 points). The average daily alcohol consumption was assessed at the start of the study and at 4, 12, and 24 weeks after its start. The five-step alcohol consumption scale of the Obsessive-Compulsive Drinking Scale (OCDS) was used. The extent of the change between the first assessment and subsequent assessment was considered the primary evaluation point. Responders were defined as subjects showing an improvement of at least two steps in the score. Patients not treated with TPM were retrospectively selected according to the same criteria on the basis of their medical records and were used as controls. The TPM group was further subdivided into responders and nonresponders.

Of the 31 subjects who consented to TPM therapy, 11 stopped or discontinued TPM, and they were considered nonresponders. The average TPM maintenance dosage (standard deviation) was 62.9 (38.1) mg. Alcohol consumption scores significantly decreased at each assessment point in the study. The percentage of responders in the TPM group (n = 31) was significantly higher than that in the control group (n = 41) at the 24-week assessment point (45.2% vs. 19.5%, p=0.0193). A significant difference was observed between responders (n = 14) and nonresponders (n = 17) only in well-educated and autistic subjects (50% vs. 5.9%, p = 0.0109).

TPM decreased the amount of alcohol consumption in alcoholics. In addition, a correlation between autistic features and TPM treatment response was suggested.