[Anticonvulsants in the treatment of alcoholism]

Fortschr Neurol Psychiatr. 2009 Apr;77(4):192-202. doi: 10.1055/s-0028-1109214. Epub 2009 Apr 3.
[Article in German]

Abstract

Because of promising data from animal studies the clinical trials on anticonvulsants for the treatment of alcohol disorder have been accumulating in the last 40 years. A comprehensive research of various data bases (MEDLINE, EMBASE, Cochrane) was performed. Here, we present the trials found together with an estimation of their evidence according to the guidelines of the "Arzneimittelkommission der deutschen Arzteschaft". We examined the clinical studies conducted for the treatment of alcohol withdrawal syndrome, for relapse prevention/consumption reduction as well as for the treatment of co-morbide psychiatric disorders. The study analysis has not resulted in any safe alternative to benzodiazepines, clomethiazole or carbamazepine in the treatment of the stronger alcohol withdrawal syndrome. The material is also insufficient with regard to relapse prevention/consumption reduction or to the treatment of co-morbide psychiatric disorders. The safest proof of effect is currently topiramate (consumption reduction) and valproate (alcohol dependence with bipolar disorder). However, first positive results must be confirmed in well controlled studies with a much longer duration. Baclofen und several anticonvulsants such as valproate, oxcarbazepine and gabapentin demonstrate a potential to aid in the treatment of alcohol disorder. Currently, there exists any published controlled study for levetiracetam, which would be well suited in the treatment of alcoholism due to its favorable safety profile and low pharmacological interaction potential.

Publication types

  • English Abstract
  • Meta-Analysis
  • Review

MeSH terms

  • Alcoholism / complications
  • Alcoholism / drug therapy*
  • Alcoholism / psychology
  • Anticonvulsants / therapeutic use*
  • Diagnosis, Dual (Psychiatry)
  • Humans
  • Long-Term Care
  • Mental Disorders / complications
  • Mental Disorders / drug therapy
  • Randomized Controlled Trials as Topic
  • Reward
  • Secondary Prevention
  • Substance Withdrawal Syndrome / drug therapy
  • Substance Withdrawal Syndrome / psychology

Substances

  • Anticonvulsants