Treatment of alcohol dependence with low-dose topiramate an open-label controlled study 英文参考文献.docVIP

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Treatment of alcohol dependence with low-dose topiramate an open-label controlled study 英文参考文献.doc

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Treatment of alcohol dependence with low-dose topiramate an open-label controlled study 英文参考文献

Paparrigopoulosetal.BMCPsychiatry2011,11:41 /1471-244X/11/41 RESEARCH ARTICLE OpenAccess Treatmentofalcoholdependencewithlow-dose topiramate:anopen-labelcontrolledstudy ThomasPaparrigopoulos1*,EliasTzavellas1?,DimitrisKaraiskos1?,GeorgiaKourlaba2?,IoannisLiappas1? Abstract Background:GABAergicanticonvulsantshavebeenrecommendedforthetreatmentofalcoholdependenceand thepreventionofrelapse.Severalstudieshavedemonstratedtopiramate’sefficacyinimprovingdrinkingbehaviour andmaintainingabstinence.Theobjectiveofthepresentopen-labelcontrolledstudywastoassessefficacyand tolerabilityoflow-dosetopiramateasadjunctivetreatmentinalcoholdependenceduringtheimmediatepost- detoxificationperiodandduringa16-weekfollow-upperiodafteralcoholwithdrawal. Methods:Followinga7-10dayinpatientalcoholdetoxificationprotocol,90patientswereassignedtoreceive eithertopiramate(upto75mgperday)inadditiontopsychotherapeutictreatment(n=30)orpsychotherapy alone(n=60).Symptomsofdepressionandanxiety,aswellascraving,weremonitoredfor4-6weeksimmediately followingdetoxificationonaninpatientbasis.Thereafter,bothgroupswerefollowedasoutpatientsataweekly basisforanother4monthsinordertomonitortheircourseandabstinencefromalcohol. Results:Amarkedimprovementindepressive(p0.01),anxiety(p0.01),andobsessive-compulsivedrinking symptoms(p0.01)wasobservedovertheconsecutiveassessmentsinbothstudygroups.However,individuals ontopiramatefaredbetterthancontrols(p0.01)duringinpatienttreatment.Moreover,duringthe4-month followupperiod,relapseratewasloweramongpatientswhoreceivedtopiramate(66.7%)comparedtothosewho receivednoadjunctivetreatment(85.5%),(p=0.043).Timetorelapseinthetopiramateaugmentationgroupwas significantlylongercomparedtothecontrolgroup(logranktest,p=0.008).Thus,mediandurationofabstinence was4weeksforthenon-medicatedgroupwhereasitreached10weeksforthetopiramategroup.Noseriousside effectsoftopiramatewererecordedthroughoutthestudy. Conclusions:Low-dosetopiramateasanadjuncttopsychotherapeutictreatmentiswelltoleratedandeffective