Title : Combination in patients with Alcohol Use Disorder A 12 Week, Randomized, Placebo Controlled Pilot Study
Alcohol use disorder has proven consistently difficult to treat with currently approved medications showing a small effect size.1 Topiramate (TPM) has shown promising results as a potential treatment of alcohol use disorder through its anti-craving effects, but its use is limited by cognitive side effects. This cognitive impairment has been attributed to increased oxidative stress in neurons due to a lack of glutathione, which requires cysteine and the cysteine-glutamate antiporter (xCT). 6 N-acetylcysteine (NAC) has the potential to reduce the cognitive impairments caused by TPM, as it does not require the use of the xCT antiporter to enter neurons and can therefore replete glutamate concentrations. NAC also has the potential to work synergistically with TPM thereby reducing alcohol craving and drinking more efficaciously than either drug alone. The current study was a randomized, double-blind pilot study designed to evaluate the effectiveness and side effect profile of the combination of TPM + NAC versus TPM + placebo. We found that both treatment groups showed a significant reduction in alcohol use at the end of the study compared to baseline. However, there was no significant difference between groups in their reduction in alcohol use. Furthermore, there was no significant difference between groups for cognitive side effects. This study supports the current evidence that TPM is an effective medication for alcohol use disorder, and that NAC may not provide additional benefit in the reduction of alcohol use or cognitive side effects.
What will audience learn from your presentation?
- Topiramate is an effective medication for reducing alcohol consumption in patients with Alcohol Use Disorder.
- Not all patients who are treated with topirmate for Alcohol Use Disorder suffer from cognitive side effects.
- N-acetylcysteine (NAC) does not appear to mitigate potential cognitive side effects from topiramate nor provide additional therapeutic benefit.