Migraine pill may help heavy drinkers, study says

CHICAGO — A migraine pill seems to help alcoholics taper off their drinking without detox treatment, researchers report, offering a potential option for a hard-to-treat problem.

The drug, Topamax, works in a different way than three other medications already approved for treating alcoholism.

Experts said the drug is likely to appeal to heavy drinkers who would rather seek help from their own doctors, rather than enter a rehab clinic to dry out. The drug costs at least $350 a month, plus the price of doctor’s visits.

Addiction specialists not involved in the study said the findings are promising, although side effects such as trouble concentrating, tingling and itching caused about one in five people to drop out of the study. Drowsiness and dizziness are also problems.

“The size of the treatment effect is larger than in most of the other medications we’ve seen,” said Dr. Mark Willenbring of the National Institute on Alcohol Abuse and Alcoholism. “And all the drinking variables changed in the right direction.”

The study followed 371 heavy drinkers for 14 weeks. About half were randomly assigned to take Topamax, also called topiramate, in gradually increasing doses. The others took dummy pills.

All volunteers were encouraged — but not required — to stop drinking.

At the start of the study, they drank, on average, 11 standard drinks daily.

By the end of the study, 27 of the 183 people, or 15 percent, who took Topamax had quit drinking entirely for seven weeks or more. That compared with six of 188, or 3 percent, in the placebo group.

Others scaled down their drinking. The Topamax group cut back to six drinks a day, on average; the placebo group cut back to seven drinks a day.

The study didn’t follow the drinkers long-term, so it’s unclear how many relapsed after they stopped taking the pill.

The drug works by inhibiting dopamine, the brain’s “feel-good” neurotransmitters that are involved in all addictions, said Stephen Dewey, a neuroscientist the Brookhaven National Laboratory, who was not involved in the study but does similar research.

The study, published in today’s Journal of the American Medical Association, was funded by the maker of the drug, Johnson &Johnson Inc.’s Ortho-McNeil Neurologics, which reviewed the manuscript but did not change the results or interpretation, the researchers reported.

On Tuesday, Dr. Sidney Wolfe, director of Public Citizen’s health research group, sent a protest letter to the U.S. Food and Drug Administration questioning the promotion of Topamax for alcoholics by researchers funded by Ortho-McNeil.

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