Cognitive changes in topiramate‐treated patients with alcoholism: A 12‐week prospective study in patients recently detoxified

Likhitsathian, Surinporn; Saengcharnchai, Pichai; Uttawichai, Kanok; Yingwiwattanapong, Jatsada; Wittayanookulluk, Apisak; Srisurapanont, Manit

doi:10.1111/j.1440-1819.2012.02326.x

Cited by 8 publications

(7 citation statements)

References 26 publications

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“…Despite these test results, the TOP group did not report more subjective complaints of memory problems than the PLA group over the course of the trial. These findings are generally consistent with previously reported mixed observations on the effects of topiramate on learning and memory (Aldenkamp et al, 2000, Lee et al, 2003), but different from Likhitsathian and coworkers (Likhitsathian et al, 2012) who found no decrease in cognitive functioning in an open trial of topiramate in AUD patients. Given the limited sample size, we were unable to conduct any meaningful statistical analyses to definitively conclude that the cognitive impairment observed in this population was caused only by topiramate treatment and was unrelated to continued alcohol consumption.…”

Section: Discussionsupporting

confidence: 92%

“…Moreover, while Likhitsathian and colleagues described cognitive changes in an open trial of topiramate in AUD (Likhitsathian et al, 2012), to our knowledge, we report the first placebo-controlled study of topiramate's neurocognitive adverse effects in a trial focusing on alcohol use. Limitations of the study include its sample size, consistent with the study's pilot nature, which may have decreased power to detect significant differences between topiramate and placebo despite there being large percent differences.…”

Section: Discussionmentioning

confidence: 80%

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Topiramate Treatment of Alcohol Use Disorder in Veterans with Posttraumatic Stress Disorder: A Randomized Controlled Pilot Trial

Batki

Pennington

Lasher

et al. 2014

Alcoholism Clin & Exp Res

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Background The course of posttraumatic stress disorder (PTSD) is frequently and severely complicated by co-occurring alcohol use disorder (AUD), yet there are few reports of pharmacologic treatments for these co-morbid conditions. The objective of this pilot study was to obtain a preliminary assessment of the efficacy and safety of topiramate in reducing alcohol use and PTSD symptoms in veterans with both disorders. Methods This was a prospective 12-week, randomized, double-blind, placebo-controlled pilot trial of flexible-dose topiramate up to 300mg/day in 30 veterans with PTSD and AUD. The primary outcome measure was frequency of drinking. Secondary outcomes consisted of other measures of alcohol use and PTSD symptom severity. Results Within-group analyses showed that topiramate treatment was associated with significant reductions in frequency and amount of alcohol use and alcohol craving from baseline through week 12. Between-group analyses showed that topiramate reduced frequency of alcohol use and alcohol craving significantly more than placebo and tended to reduce drinking amount. Topiramate treatment was also associated with decreased PTSD symptom severity and tended to reduce hyperarousal symptoms compared to placebo. Topiramate transiently impaired learning and memory, with significant recovery by the end of treatment. Conclusions These preliminary results indicate that in veterans with co-occurring PTSD and AUD, topiramate may be effective in reducing alcohol consumption, alcohol craving, and PTSD symptom severity – particularly hyperarousal symptoms.. Topiramate was associated with transient cognitive impairment but was otherwise well tolerated.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 80%

Topiramate Treatment of Alcohol Use Disorder in Veterans with Posttraumatic Stress Disorder: A Randomized Controlled Pilot Trial

Batki

Pennington

Lasher

et al. 2014

Alcoholism Clin & Exp Res

View full text Add to dashboard Cite

show abstract

“…These impairments are frequent in psychoactive substance users and can affect a large set of cognitive functions: problem resolution, learning, memory, etc. Previous research stated that cognitive impairments could act on care efficacy, treatment outcomes or substance use during treatment (Aharonovich, Nunes, & Hasin, 2003;Likhitsathian et al, 2012;Marceau, Lunn, Berry, Kelly, & Solowij, 2016).…”

Section: Factors Predicting Dropout Of Addiction-specialized Treatmentmentioning

confidence: 99%

Outpatient Addiction Treatment for Problematic Alcohol Use: What Makes Patients Who Dropped Out Different from Those Who Did Not?

Wagner

Acier

Dietlin³

2018

Substance Use & Misuse

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Tailored motivational interventions could be offered to ambivalent patients, especially during the beginning of the treatment and some significant periods of the year. A particular focus should be brought on patients presenting such profiles in terms of level of alcohol problems, inclinations to drink and motivation to change. Overall, the study provides elements to better understand what may bring one patient to drop out of the treatment, and to improve the continuity of care.

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“…Another 12-week, double-blind placebo-controlled study revealed that, in addition to reducing drinking and craving, topiramate improved performance in impulsivity paradigms [106]. Even though cognitive complaints are common, cognitive improvement (likely due to abstinence or decreased drinking outweighing topiramate's cognitive adverse effects) was observed at the end of an 85-day trial of flexible-dose topiramate (50–300 mg/day) [107]. …”

Section: Anticonvulsants For the Treatment Of Harmful Drinking Pattmentioning

confidence: 99%

Anticonvulsants for the Treatment of Alcohol Withdrawal Syndrome and Alcohol Use Disorders

et al. 2015

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Alcoholic patients suffer from harmful allostatic neuroplastic changes in the brain causing an acute withdrawal syndrome upon cessation of drinking followed by a protracted abstinence syndrome and an increased risk of relapse to heavy drinking. Benzodiazepines have long been the treatment of choice for detoxifying patients and managing alcohol withdrawal syndrome (AWS). Non-benzodiazepine anticonvulsants (NBACs) are increasingly being used both for alcohol withdrawal management and for ongoing outpatient treatment of alcohol dependence, with the goal of either abstinence or harm reduction. This expert narrative review summarizes the scientific basis and clinical evidence supporting the use of NBACs in treating AWS and for reducing harmful drinking patterns. There is less evidence in support of NBAC therapy for AWS, with few placebo-controlled trials. Carbamazepine and gabapentin appear to be the most promising adjunctive treatments for AWS, and they may be useful as monotherapy in select cases, especially in outpatient settings and for the treatment of mild-to-moderate low-risk patients with the AWS. The body of evidence supporting the use of the NBACs for reducing harmful drinking in the outpatient setting is stronger. Topiramate appears to have a robust effect on reducing harmful drinking in alcoholics. Gabapentin is a potentially efficacious treatment for reducing the risk of relapse to harmful drinking patterns in outpatient management of alcoholism. Gabapentin's ease of use, rapid titration, good tolerability, and efficacy in both the withdrawal and chronic phases of treatment make it particularly appealing. In summary, several NBACs appear to be beneficial in treating AWS and alcohol use disorders.

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Cognitive changes in topiramate‐treated patients with alcoholism: A 12‐week prospective study in patients recently detoxified

Cited by 8 publications

References 26 publications

Topiramate Treatment of Alcohol Use Disorder in Veterans with Posttraumatic Stress Disorder: A Randomized Controlled Pilot Trial

Topiramate Treatment of Alcohol Use Disorder in Veterans with Posttraumatic Stress Disorder: A Randomized Controlled Pilot Trial

Outpatient Addiction Treatment for Problematic Alcohol Use: What Makes Patients Who Dropped Out Different from Those Who Did Not?

Anticonvulsants for the Treatment of Alcohol Withdrawal Syndrome and Alcohol Use Disorders

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