Pill Helps Alcoholics Taper Off Drinking

Tom Wolfe, 44, sits outside his Earlysville, Va., home, Tuesday, Oct. 9, 2007. Wolfe, a carpenter, said he has been sober for two years thanks to Topamax. The drug Topamax, a migraine pill seems to help alcoholics taper off their drinking without detox treatment, researchers report, offering a potential option for a hard-to-treat problem. (AP Photo/Matthew Rosenberg) (Matthew Rosenberg - AP)

The study didn't follow the drinkers long-term, so it's unclear how many relapsed after they stopped taking the pill.

But there were lasting effects for Tom Wolfe, 44, a carpenter from Earlysville, Va., who said he has been sober for two years thanks to Topamax. After years of heavy drinking, he took part in an earlier Topamax study. He felt "a little lightheaded" at first until he got used to the drug. Alcohol lost its enjoyment, strengthening his resolve to quit.

"It's been a miracle to me," Wolfe said. "It got the monkey off my back."

The drug works by inhibiting dopamine, the brain's "feel-good" neurotransmitters that are involved in all addictions, said Stephen Dewey, a neuroscientist the Brookhaven National Laboratory, who was not involved in the study but does similar research.

It's a new approach, he said, that "clearly did work on a very small subset in the population."

Willenbring, who wrote an accompanying editorial, predicts that a future pill, although probably not Topamax, will do for alcohol dependence what Prozac did for depression: Remove the stigma.

Prozac changed the nature of depression treatment 20 years ago by allowing patients to see their family doctors for help, Willenbring said. An effective drug with few side effects could do the same for alcoholism treatment, he said.

"This is a huge market," Willenbring said. "We're approaching a Prozac moment."

But Topamax has big obstacles. With the drug maker's patent expiring next year, there won't be any big push to advertise it for alcoholism, Willenbring said.

Doctors are free to prescribe drugs for uses that have not been approved, but drug companies are prohibited by law from marketing drugs for these so-called "off-label" uses.

On Tuesday, Dr. Sidney Wolfe, director of Public Citizen's health research group, sent a protest letter to the U.S. Food and Drug Administration questioning the promotion of Topamax for alcoholics by researchers funded by Ortho-McNeil.

"This is a very bad message to send out," Wolfe said.

Ortho-McNeil has no plans to seek federal approval for the drug as an alcoholism treatment and promotes it only for its approved uses of migraine prevention and epilepsy, said company spokeswoman Tricia Geoghegan. The company dropped development of new uses for the drug in 2004, but has continued to support some research.

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