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Topiramate, a derivative of the naturally occurring sugar monosaccharide D-fructose, has been found effective in helping alcoholics quit or cut back on the amount they drink. Evidence suggests that topiramate antagonizes excitatory glutamate receptors, inhibits dopamine release, and enhances inhibitory gamma-aminobutyric acid function. A 2008 review of the effectiveness of topiramate concluded that the results of published trials are promising, however as of 2008, data was insufficient to support using topiramate in conjunction with brief weekly compliance counseling as a first-line agent for alcohol dependence.[156] A 2010 review found that topiramate may be superior to existing alcohol pharmacotherapeutic options. Topiramate effectively reduces craving and alcohol withdrawal severity as well as improving quality-of-life-ratings.[157] Baclofen, a GABAB receptor agonist, is under study for the treatment of alcoholism.[158] A systematic review concluded that there is insufficient evidence for the use of baclofen for withdrawal symptoms in alcoholism.[159] There is tentative data supporting baclofen in alcohol dependence however further trials are needed as of 2013.[160] Ondansetron, a 5HT3 antagonist, appears promising.[161] |
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