Posttreatment Effects of Topiramate Treatment for Heavy Drinking

作者：Kranzler Henry R^*; Wetherill Reagan; Feinn Richard; Pond Timothy; Gelernter Joel; Covault Jonathan

来源：Alcoholism: Clinical and Experimental Research , 2014, 38(12): 3017-3023.

DOI：10.1111/acer.12578

• Topiramate
• Heavy Drinkers
• Posttreatment Follow-Up
• GRIK1
• rs2832407

BackgroundWe examined whether the effects of topiramate and a single nucleotide polymorphism (rs2832407) in GRIK1, which encodes a kainate receptor subunit, persisted following a 12-week, placebo-controlled trial in 138 heavy drinkers with a treatment goal of reduced drinking. During treatment, topiramate 200mg/d significantly reduced heavy drinking days and increased the frequency of abstinent days (Am J Psychiatry, 2014, 171:445). In the European-American (EA) subsample (n=122), rs2832407 moderated the treatment effect on heavy drinking. %26lt;br%26gt;MethodsPatients were re-interviewed 3 and 6months after the end of treatment. During treatment, we obtained 92.4% of drinking data, with 89.1 and 85.5% complete data at the 3- and 6-month follow-up visits, respectively. We examined 4 outcomes over time in the overall sample and the EA subsample: percent heavy drinking days (PHDD), percent days abstinent (PDA), serum -glutamyl transpeptidase (GGTP) concentration, and a measure of alcohol-related problems. %26lt;br%26gt;ResultsIn the full sample, the lower PHDD and higher PDA seen with topiramate treatment were no longer significant during follow-up. Nonetheless, the topiramate-treated patients had lower alcohol-related problem scores during treatment and both follow-up periods. Further, in the EA subsample, the greater reduction in PHDD seen with topiramate treatment in rs2832407*C-allele homozygotes persisted throughout follow-up, with no significant effects in A-allele carriers. A reduction in GGTP concentration was consistent with the reduction in heavy drinking, but did not reach statistical significance. %26lt;br%26gt;ConclusionsThere are persistent therapeutic effects of topiramate in heavy drinkers, principally in rs2832407*C-allele homozygotes.

• 出版日期2014-12