there is hope !!

horizontal rule

Index

Assessment

I need help

People Dimension

FAQ

Information

I want to help

Search this site

Site Map

 

Medication (advantages and dangers)

Abstinence

Anti-depression

Medicines that are used to cause abstinence

Disulphiram

Topiramate 

***

From http://www.eurekalert.org/pub_releases/2003-05/uoth-sdi051503.php Contents dated as May 2003

The following is an excerpt. For the full article click the above link.

Seizure drug improves abstinence from drinking, study shows

Patients taking oral topiramate were 6 times more likely to be alcohol-free for a month during trial

San Antonio, Texas, U.S.A. (May 15) Hailed as a landmark discovery that is likely to change the direction of clinical alcoholism treatment, researchers at The University of Texas Health Science Center at San Antonio today announced that topiramate, a derivative of the naturally occurring sugar monosaccharide D-fructose, is effective at promoting abstinence among alcohol-dependent individuals.

Reported in the May 17 issue of The Lancet, this study conducted by Professor Bankole A. Johnson, M.D., Ph.D., and colleagues was carried out at the Health Science Center's dynamic South Texas Addiction Research & Technology (START) Center, where more than 100 professionals develop new medications for treating alcohol and drug dependence.... "Remarkably, all 150 patients were enrolled into this clinical trial while they were still drinking heavily  ...  Patients who took topiramate were six times more likely than those who received placebo to be continuously abstinent for at least one month during the three-month trial. Over the same period, those taking the placebo were four times more likely to drink heavily for an entire month during the trial."

Alcohol-dependent patients frequently have liver disease, one indicator of which is a rise in the plasma level of the enzyme gamma glutamyl transferase (GGT). "It is of considerable clinical importance that topiramate was superior to placebo at significantly reducing the plasma GGT levels during the trial," Professor Johnson said. "Further, topiramate was shown to be effective treatment for all types of alcohol-dependent patients." Topiramate already is an approved anti-seizure drug.

"The strength of their findings is likely to change the direction of clinical alcoholism treatment and will be welcome news for practitioners," said Robert Malcolm, M.D., of the Center for Drug and Alcohol Programs at the Medical University of South Carolina, where he is associate dean and professor of psychiatry and family medicine. He said "the results of Professor Johnson's study suggest that topiramate, even in low doses early in treatment, has the capacity to ameliorate the turbulence of anxiety and mood instability that accompanies cessation from alcohol. Topiramate also produced a robust effect on improving maintenance of abstinence and reduced alcohol use. A single pharmacologic agent that enhances early abstinence, stabilizes mood and anxiety symptoms, and promotes long-term abstinence with only modest psychosocial intervention is indeed a remarkable treatment advance."

R. Adron Harris, Ph.D., the M. June and J. Virgil Waggoner Professor and director of the Waggoner Center for Alcohol and Addiction Research at The University of Texas at Austin, said topiramate is from a different class of drug than those previously used in the treatment of alcoholism. "It offers a new choice for alcoholism," he said. "Certainly not every patient will benefit from this drug or others, but because it is a different kind of drug than what is currently approved or in trials, it offers the possibility of bringing benefits to patients for whom other drugs are not successful. If this were a 'me-too' drug, or a variation on an existing drug, it would not be as important as a new class of drug being applied in this way."

end of article

***

The following are common medications that are used in getting an alcoholic to abstain.
bullet

Antabuse

bullet

Dipsan

Effects of Disulphiram

Disulphiram is the active ingredient in medicines that make the use of alcohol very unpleasant.

 When alcohol is broken down in the body a poison, acetaldehyde, is released in manageable quantities that are then further broken down.  However when a chemical patch/implant is used the breaking down of the acetaldehyde is retarded. This leads to a quick escalation of the poison in the body with very unpleasant effects on the drinker. These unpleasant effects are supposed to prevent the drinker from using alcohol. Besides severe physical effects, one of the psychological effects is a general feeling of fear. This leaves the person feeling insecure and having a lack of perseverance.

 Anti-depressants and alcoholism

Alcohol Cravings Induced via Increased Serotonin

http://www.drugawareness.org/Archives/Miscellaneous/MRalcohol.html

by Ann Blake Tracy, Director, ICFDA

There is an alarming connection between alcoholism and the various prescription drugs that increase serotonin. The most popular of those drugs are: PROZAC, ZOLOFT, PAXIL, LUVOX, SERZONE, EFFEXOR, ANAFRANIL, and the new diet pills, FEN-PHEN and REDUX. 

 

For seven years numerous reports have been made by reformed alcoholics (some for 15 years and longer) who are being "driven" to alcohol again after being prescribed one of these drugs. And many other patients who had no previous history of alcoholism have continued to report an "overwhelming compulsion" to drink while using these drugs.

(A few personal accounts: #1 A young woman, a recovering alcoholic, reported that during the eight month period she had been using Prozac she found it necessary to attend AA meetings every day in order to fight off the strong compulsions to begin drinking again. #2 In the Southeastern United States a middle aged psychologist, also a recovering alcoholic, after being prescribed Prozac, found herself needing to attend AA meetings morning, noon, and night to keep from destroying the sobriety she had achieved. #3 A young father, who was Mormon and had never before in his life used alcohol, found himself drinking Ever Clear and exhibiting bizarre as well as violent behavior, after being prescribed Prozac and Ritalin. #4 A young mother who had never used alcohol before began drinking large amounts within weeks of being prescribed Prozac and quickly found herself committed to a mental institution due to the psychotic behavior that resulted. Added to her Prozac prescription were anti-psychotic meds and electric shock treatments. She then began to experience seizures and was started on anti-seizure meds. #5 A concerned neighbor reported her friend was drinking straight Vodka on a regular basis after being prescribed Zoloft. #6 A daughter reported her father, sober for 15 years, began drinking again on Prozac. The consistant report from these patients has been an "overwhelming craving or compulsion" for alcohol.)

 

For some time we did not have specific medical documentation to help us understand why this was happening. Could it be that Prozac, Zoloft, Paxil, etc., being mood altering substances, were removing the inhibitions that individuals had placed upon themselves to stop their additions? But beyond this mood altering effect of Prozac, etc., there seemed to be a physiological cause for this alcoholic obsession as well. There were reports of people who rarely drank before Prozac, etc., consuming excessive amounts of alcohol after starting usage of these various drugs. For example we have the case of a young newly wed in Southern Utah who was given Prozac for a hormonal imbalance. Before that time she would have two or three social drinks a year, yet soon after being prescribed Prozac she began bringing alcohol home by the case. Many similar reports followed.

 

Could it be that because these drugs have such a strong adverse effect upon the pancreas [Manufacturer's warnings include such side effects as hypoglycemia, diabetes and pancreatitis.] they are producing a potent disruption in the body's blood sugar balance? This would in turn cause a "craving" for alcohol as the body reaches out for a "quick fix" to raise the blood sugar level thus triggering a vicious self-perpetuating cycle as the alcohol pushes the blood sugar level even lower after the brief high it produces. This means that those suffering a tendency toward alcoholism or any other blood sugar disorder would suffer the most disastrous repercussions of Prozac, etc., (including psychosis, suicidal ideation and violence) much faster than most. Patient reports support this conclusion.

In November of 1994 Yale published a study that gave us one answer to the alcohol cravings associated with these drugs. The study demonstrated that an increase in brain levels of either of two neurotransmitters (brain hormones), serotonin or noradrenalin, produces: #1 a craving for alcohol, #2 anger, #3 anxiety. They found this to be especially true for those who have a history of alcoholism. All of the drugs listed above are designed in one way or another to increase serotonin which in turn also increases noradrenalin. Anyone who has a history of alcoholism should heed the warning contained in these reports. And anyone who has developed a problem with alcoholism while using these drugs deserves answers as to why they have experienced such an overwhelming compulsion to drink.

 

America already has an estimated 10 -15 million alcoholics. To increase that number with a reaction from prescription drugs which causes a compulsion to drink is a tragedy! What a sad state of affairs that drugs which are actually being promoted as a treatment for alcoholism have the potential to create alcohol craving behavior. This is not only frightening, but absurd. It is heart-rending to listen to those who have had years of sobriety destroyed almost overnight or those who have never touched alcohol before Prozac, yet began drinking compulsively due to a medication prescribed by doctors unfamiliar with this connection. By chemically inducing an overwhelming urge to drink this effect also causes patients to mix alcohol with these powerful drugs. When alcohol and drugs are combined, one can compound the effects of the other so the resulting impairment is far worse than if the two were taken separately...even small amounts, mixed with some medicines, will deaden your senses or change your perceptions which can lead to psychotic behavior, seizures, etc. Those in this situation need to be made aware that they are not alone, and that this is a common report which is now substantiated by medical documentation. They also need to understand that it is possible to very gradually withdraw from these drugs and overcome these adverse drug reactions.

 

For an in depth exploration of this subject see the book PROZAC: PANACEA OR PANDORA? by Ann Blake Tracy. For order information call 1-800-280-0730 or visit the website.

Other references for this material: Krystal JH, Webb; E, Cooney N.; et al., "Specificity of Ethanol-like Effects Elicited in Serotonergic and Noradrenergic Mechanisms," ARCHIVES OF GENERAL PSYCHIATRY, Vol. 51, Issue 11, pgs 898-911. (This is the Yale study mentioned above.); In a study conducted by Liisa Ahtee and Kalervo Eriksson (Physiology and Behavior, Vol. 8, pp. 123-126, 1972) rats which preferred alcohol had 15-20% higher concentrations of serotonin in the brain

Last updated 18 April 2007

horizontal rule

Back to index.    Disclaimer: Although reasonable effort has been applied to maintain the integrity of the data and advice on this site, no responsibility can be accepted for the use thereof. It is a resource guide for understanding and managing alcoholism. The information on this site is provided "as is" for general information and is not intended as a substitute for the diagnosis or treatment recommendation of a qualified health care professional.    Enquiries regarding this web site should be directed to support@alcohol.co.za