Anticonvulsants have been used for the treatment of affective and anxiety symptoms secondary to alcohol abuse as well as craving. In this open label study we investigated efficacy of topiramate as an adjunct in alcohol detoxification; end targets were anxiety, depression and in obsessive-compulsive drinking.

Two groups matched for age, alcohol consumption and demographic characteristics, were treated either with psychotherapy (n=43) or psychotherapy and topiramate (n=43). Subjects were assessed twice (baseline and after a 4-6 week detoxification period) by the Hamilton Anxiety Rating Scale, the Hamilton Depression Rating Scale, and the Obsessive Compulsive Drinking Scale. T-tests were used for comparisons between groups.

Following detoxification, psychopathology significantly subsided in both groups; however, improvement was more robust in the topiramate group (table 1).

Topiramate in conjunction with a short-term psychotherapeutic approach may help the alcohol detoxification process by minimizing craving and subjective physical discomfort. Moderate to severe anxiety and depressive symptoms with concomitant poor functioning were present in all subjects before treatment. Following 4-6 weeks of alcohol detoxification, a considerable improvement in terms of anxiety and depressive symptoms was observed in both groups. However, in our sample, a significantly more robust decrease was recorded in the topiramate augmentation group. Consequently, topiramate can be of potential help in this population and can be used as an alternative among other treatment options.