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alcoholism and topiramate

Alex H S Harris, Thomas Bowe, Hildi Hagedorn, Andrea Nevedal, Andrea K Finlay, Risha Gidwani, Craig Rosen, Chad Kay, Melissa Christopher
BACKGROUND: Active consideration of effective medications to treat alcohol use disorder (AUD) is a consensus standard of care, yet knowledge and use of these medications are very low across diverse settings. This study evaluated the overall effectiveness a multifaceted academic detailing program to address this persistent quality problem in the US Veterans Health Administration (VHA), as well as the context and process factors that explained variation in effectiveness across sites. METHODS: An interrupted time series design, analyzed with mixed-effects segmented logistic regression, was used to evaluate changes in level and rate of change in the monthly percent of patients with a clinically documented AUD who received naltrexone, acamprosate, disulfiram, or topiramate...
September 15, 2016: Addiction Science & Clinical Practice
R C Crist, G A Doyle, K M Kampman, W H Berrettini
INTRODUCTION: An intronic polymorphism in the delta-opioid receptor gene (OPRD1) was previously associated with cocaine dependence in African-Americans. However, it is not known if the polymorphism (rs678849) is associated with dependence-related phenotypes within the cocaine dependent population. METHODS: Cocaine and alcohol dependent subjects were randomized to either topiramate or placebo. Abstinence from cocaine use was confirmed by urine drug screens for benzoylecgonine three times per week...
September 1, 2016: Drug and Alcohol Dependence
Mohammadrasoul Khalkhali
Background. Topiramate (TPM) is a psychotropic drug, which is used mainly as an antiepileptic drug and now over the years is used for a wider range of indications, including migraine prophylaxis and binge eating disorders. Although ocular side effects of Topiramate have been frequently reported, neuroophthalmologic manifestations such as myokymia are rarely reported. Case Presentation. This case report presents a case of a 47-year-old woman who had begun TPM for binge eating problem. She developed unilateral long standing lower eyelid twitching, which progressed to upper eyelid and eyebrow at the same side...
2016: Case Reports in Psychiatry
Eunmi Kim, Sanggil Choe, Juseon Lee, Moonhee Jang, Hyeyoung Choi, Heesun Chung
Since driving under the influence of drugs (DUID) is as dangerous as drink-driving, many countries regulate DUID by law. However, laws against the use of drugs while driving are not yet established in Korea. In order to investigate the type and frequency of drugs used by drivers in Korea, we analyzed controlled and non-controlled drugs in alcohol-positive blood samples. Total 275 blood samples were taken from Korean drivers, which were positive in roadside alcohol testing. The following analyses were performed: blood alcohol concentrations by GC; screening for controlled drugs by immunoassay and confirmation for positive samples by GC-MS...
August 2016: Forensic Science International
Agnieszka Michalak, Grazyna Biała
The consequences of alcohol dependence concern serious health care, social and economic problems. The scope of many studies is to better understand mechanisms underlying alcohol addiction in order to work out new, more effective treatment strategies. Alcohol affects many neurotransmission systems within the brain. In general, acute alcohol enhances inhibitory transmission, up-regulating the GABAergic system and impairing glutamatergic function, therefore interfering the balance between excitatory and inhibitory synaptic inputs...
January 2016: Acta Poloniae Pharmaceutica
Bradford T Winslow, Mary Onysko, Melanie Hebert
The U.S. Preventive Services Task Force recommends that clinicians screen adults for alcohol misuse and provide persons engaged in risky or hazardous drinking behaviors with brief behavioral counseling to reduce alcohol misuse. However, only a minority of American adults with high-risk alcohol use receive treatment. Three medications are approved by the U.S. Food and Drug Administration to treat alcohol use disorder: acamprosate, disulfiram, and naltrexone. Acamprosate and naltrexone reduce alcohol consumption and increase abstinence rates, although the effects appear to be modest...
March 15, 2016: American Family Physician
Raye Z Litten, Bonnie B Wilford, Daniel E Falk, Megan L Ryan, Joanne B Fertig
Alcohol use disorder (AUD), as currently defined in the Diagnostic and Statistical Manual, 5th Edition (DSM-5), is a heterogeneous disorder stemming from a complex interaction of neurobiological, genetic, and environmental factors. As a result of this heterogeneity, there is no one treatment for AUD that will work for everyone. During the past 2 decades, efforts have been made to develop a menu of medications to give patients and clinicians more choices when seeking a therapy that is both effective and which has limited side effects...
April 2016: Substance Abuse
Louisa G Sylvia, Alexandra K Gold, Jonathan P Stange, Andrew D Peckham, Thilo Deckersbach, Joseph R Calabrese, Roger D Weiss, Roy H Perlis, Andrew A Nierenberg, Michael J Ostacher
BACKGROUND AND OBJECTIVES: Topiramate is effective for alcohol use disorders (AUDs) among non-psychiatric patients. We examined topiramate for treating comorbid AUDs in bipolar disorder (BD). METHODS: Twelve participants were randomized to topiramate or placebo for 12 weeks. RESULTS: The topiramate group, with two out of five participants (40%) completing treatment, experienced less improvement in drinking patterns than the placebo group, with five out of seven participants (71%) completing treatment...
March 2016: American Journal on Addictions
Ignacio Novo-Veleiro, Lucía Alvela-Suárez, Antonio-Javier Chamorro, Rogelio González-Sarmiento, Francisco-Javier Laso, Miguel Marcos
Alcohol consumption and hepatitis C virus (HCV) infection have a synergic hepatotoxic effect, and the coexistence of these factors increases the risk of advanced liver disease. The main mechanisms of this effect are increased viral replication and altered immune response, although genetic predisposition may also play an important role. Traditionally, HCV prevalence has been considered to be higher (up to 50%) in alcoholic patients than in the general population. However, the presence of advanced alcoholic liver disease (ALD) or intravenous drug use (IDU) may have confounded the results of previous studies, and the real prevalence of HCV infection in alcoholic patients without ALD or prior IDU has been shown to be lower...
January 28, 2016: World Journal of Gastroenterology: WJG
Philip Crowley
Drug therapy for alcohol dependence should only be used in conjunction with a comprehensive treatment plan. Naltrexone and acamprosate have well established efficacy and are first-line treatments. Naltrexone is recommended for patients aiming to cut down their alcohol intake who do not have severe liver disease or an ongoing need for opioids. Acamprosate is recommended for those who have achieved and wish to maintain abstinence. Disulfiram is no longer considered first-line treatment due to difficulties with compliance and toxicity...
April 2015: Australian Prescriber
Sarah G Helton, Falk W Lohoff
Alcohol use disorders (AUDs) represent a significant health burden worldwide. Currently, there are three medications approved by the U.S. Food and Drug Administration for the treatment of AUDs, and other drugs are being prescribed off-label for this purpose. However, response rates for pharmacologic treatment are low, and extant research suggests that treatment effects may partially depend on genetic factors. Personalized medicine, or using a patient's genetics and/or personal history to determine efficacy of treatment prior to prescription, is an emerging tool that will help clinicians treat their patients more effectively and safely...
December 15, 2015: Psychiatry Research
A Kenison Roy, Chenen Hsieh, Kathleen Crapanzano
Dextromethorphan, an antitussive (cough suppressant) drug of the morphinan class with sedative and dissociative properties found in cough syrup and other over-the-counter products, is also a substance of abuse, seen primarily in young adults all over the world. A case of dextromethorphan use disorder is presented in a 45-year-old women. Her repeated attempts at abstinence were unsuccessful secondary to continued intense cravings. Treatment with topiramate resulted in complete resolution of her cravings. Topiramate was chosen empirically because of a common action with dextromethorphan in the NMDA system...
November 2015: Journal of Addiction Medicine
Narayana Manjunatha, Vivek Benegal
OBJECTIVES: Priapism, or prolonged penile erection in the absence of sexual stimulation, may be a medical emergency. Many medications including antianxiety, antidepressants and antipsychotics have been implicated. This paper presents a case of priapism associated with topiramate use. METHODS: This is a description of case report where topiramate was prescribed as anticraving medication in a patient with alcohol dependence. Episodic priapism developed soon after topiramate was prescribed...
November 2015: General Hospital Psychiatry
Paolo Martelletti
The therapeutic management of cluster headache is based on a very stable triad of drugs. Acute treatment has, in subcutaneous sumatriptan, its gold standard if compared to pure oxygen or indomethacin. Preventative treatment is based on verapamil at high doses (≥ 360 mg) and is a gold standard if compared to lithium carbonate or topiramate. Transitional treatments, based on the short-term use of corticosteroids with either systemic or local administration (GON), can be useful for the suppression of most resistant cluster periods, but with a well-known carry-over phenomenon related to the length of the cluster period itself...
2015: Expert Opinion on Pharmacotherapy
Majid Motaghinejad, Mohammad Yasan Bangash, Ozra Motaghinejad
Relieving withdrawal and post-abstinence syndrome of alcoholism is one of the major strategies in the treatment of alcohol addicted patients. Diazepam, chlordiazepoxide, and topiramate are the approved medications that were used for this object. To assess the role of non-pharmacologic therapy in the management of alcohol withdrawal syndrome, we analyzed effects of forced exercise by treadmill on alcohol dependent mice as an animal model. A total of 60 adult male mice were divided into 5 groups, from which 4 groups became dependent to alcohol (2 g/kg/day) for 15 days...
2015: Acta Medica Iranica
Silvia Minozzi, Michela Cinquini, Laura Amato, Marina Davoli, Michael F Farrell, Pier Paolo Pani, Simona Vecchi
BACKGROUND: Cocaine dependence is a major public health problem that is characterised by recidivism and a host of medical and psychosocial complications. Although effective pharmacotherapy is available for alcohol and heroin dependence, none is currently available for cocaine dependence, despite two decades of clinical trials primarily involving antidepressant, anticonvulsivant and dopaminergic medications. Extensive consideration has been given to optimal pharmacological approaches to the treatment of individuals with cocaine dependence, and both dopamine antagonists and agonists have been considered...
2015: Cochrane Database of Systematic Reviews
M Soyka, M Lieb
INTRODUCTION: Alcohol use disorders are common, but only a small minority of patients receive adequate treatment. Cognitive-behavioural therapies, motivational enhancement interviewing and brief interventions are established treatments, but few pharmacotherapies are available. AREAS COVERED: This narrative focuses on the neurobiological basis of alcohol use disorders and on emerging drugs that either have recently been approved or look likely to find their way into clinical practice...
July 2015: Pharmacopsychiatry
Silvia Minozzi, Laura Amato, Marina Davoli, Michael F Farrell, Anelise A R L Lima Reisser, Pier Paolo Pani, Mauricio Silva de Lima, Bernardo G O Soares, Simona Vecchi
No abstract text is available yet for this article.
2015: Cochrane Database of Systematic Reviews
Catherine F Moore, Wendy J Lynch
RATIONALE: Despite epidemiological and clinical data indicating marked gender differences in alcohol use disorders (AUDs), few preclinical studies have examined sex differences in animal models of AUDs. OBJECTIVE: The purpose of this study was to first characterize sex differences in ethanol consumption and reinforcement in an alcohol preferring (P) rat model of alcoholism, then use this model to screen pharmacological treatments for sex-specific effects. METHODS: Ethanol consumption was first assessed in male and female P rats under a three-bottle free-choice procedure...
February 21, 2015: Pharmacology, Biochemistry, and Behavior
Antonio Mirijello, Cristina D'Angelo, Anna Ferrulli, Gabriele Vassallo, Mariangela Antonelli, Fabio Caputo, Lorenzo Leggio, Antonio Gasbarrini, Giovanni Addolorato
Symptoms of alcohol withdrawal syndrome (AWS) may develop within 6-24 h after the abrupt discontinuation or decrease of alcohol consumption. Symptoms can vary from autonomic hyperactivity and agitation to delirium tremens. The gold-standard treatment for AWS is with benzodiazepines (BZDs). Among the BZDs, different agents (i.e., long-acting or short-acting) and different regimens (front-loading, fixed-dose or symptom-triggered) may be chosen on the basis of patient characteristics. Severe withdrawal could require ICU admission and the use of barbiturates or propofol...
March 2015: Drugs
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