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January 20th, 2007, 09:50 PM
July 19 - Alcoholism can be exceedingly difficult to treat, but doctors have found an existing drug that may provide new help. The drug may even help treat another form of addiction.

A day at the lake is a perfect day for Tom. He's finally able to enjoy time alone after battling alcoholism for six years.

The addiction destroyed everything that once mattered.

Tom, alcoholic: "I lost a career because of that. I broke up. It helped break up my marriage."

Tom would drink up to 10 glasses of whisky a day.

Tom, alcoholic: "It's miserable. Basically, your life doesn't belong to you anymore. You're consumed with consuming alcohol."

But today, Tom can focus on other things, like fishing, thanks to a new drug called Topiramate.

Doctor Bankole Johnson says the drug is one of the first that targets the brain in alcoholics.

Bankole Johnson, MD, DSC, physician neuroscientist: "What we are trying to show is that alcohol dependence is actually a brain disease in the same way other brain diseases are like migraine or epilepsy."

Topiramte was first used as an anti-convulsant medication treating epilepsy. Then doctors realized it can slow the effects of dopamine in the brain. Now doctors are using it to treat binge eating and alcoholism, and finding it can have a real effect.

In a 12-week study, those who took the drug were six-times more likely to stop drinking than those who took a placebo pill. That's impressive

Bankole Johnson, MD, DSC, physician neuroscientist: "I think this is very exciting."

Another exciting -- but accidental -- finding was the drug also helped smokers reduce their cravings.

Since the study, Tom has been sober for more than nine months.

Tom, alcoholic: "It was like a miracle to me. I'm getting my life back, and it feels great."

And now Tom is looking forward to the future.

Patients in the study took the drug once-a-week for 12 weeks. Doctors are now starting another, larger trial with alcoholics and smokers in hopes of getting FDA approval.

Research Summary:
July 19 - For most people, a glass of wine with dinner or a mug of beer with friends is no big deal. But for millions of people, alcohol is a problem.

Nearly 17.6 million adult Americans abuse alcohol or are alcoholic. Millions of adults also binge drink or drink heavily on a regular basis, which could lead to an even more serious problems. Moderate alcohol use can be pleasant and even healthy. Experts recommend up to two drinks per day for men and one drink per day for women and older people. A standard drink is one 12-ounce bottle or can of either beer or wine cooler, one five-ounce glass of wine, or 1.5 ounces of 80-proof distilled spirits. More than half of American adults report at least one family member has a problem with alcohol. Alcohol abuse can be deadly. Heavy drinking can increase the risk for certain cancers, especially those of the liver, esophagus, throat, and larynx. Far more likely is liver cirrhosis and brain damage. Pregnant women who drink place their unborn fetus in great harm. Being intoxicated increases the risk of car accidents. Alcohol-related problems cost society approximately $185 billion per year.

NEW TREATMENT: Aside from rehab programs that focus on behavioral change, researchers are studying drugs that could help an alcoholic stop craving alcohol. Bankole Johnson, M.D. chief of the University of Virginia's Department of Psychiatric Medicine, tested a new use for the medication topiramate. "One of the problems with psychological treatments is approximately 40 to 70 percent of people will relapse after one year," says Dr. Johnson. He says topiramate may be a way to help alcoholics resist relapse. The drug affects brain pathways that are related to the drive for drinking. "So it curbs the craving for addiction or alcohol by reducing effects at one particular neurotransmitter called dopamine," says Dr. Johnson. The drug is also used to treat convulsions and migraines. "So that tends to tell us that the underpinnings of alcohol dependence and also drug dependence might be related to a variety of brain disorders," he says. In a clinical trial, researchers found that the study subjects who took topiramate were significantly more likely to not relapse within the time of the study than those who did not take topiramate. There are some side effects reported with use of topiramate. "The most common side effect is drowsiness, and sometimes sedation associated with drowsiness. Some of the patients reported some other side effects like tingling in the fingers, or tingling in the mouth, but those tend to pass away after about a week of being on the drug," says Dr. Johnson.

STOP SMOKING: An unexpected side effect of the study was that topiramate also seemed to help patients quit smoking as well. Researchers found that smoking cessation rates for patients taking topiramate was three-times greater than for those who received a placebo.

FUTURE: Dr. Johnson says more extensive studies on topiramate are needed before the drug would be available to the public. He says other studies will look at the effect of combining more than one medication for addiction treatment. "What we've found is that sometimes by combining two medications, you get a much bigger effect than having a single medication."

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