The Use of Sodium Valproate in the Treatment of Alcoholism

Gy, Minuk; Ge, Rockman; Gb, German; Dr, Duerksen; Borrett, G; Hoeschen, L.E.

doi:10.1300/j069v14n02_07

Cited by 17 publications

(4 citation statements)

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“…Due to its hypothesized ability to increase GABAergic tone and efficacy as a mood stabilizer, divalproex has been studied for alcoholism treatment [62, 63]. A 12-week, double-blind, placebo-controlled pilot study including 39 subjects (31 men and 8 women) with DSM-IV-diagnosed alcohol dependence by Brady et al [64] showed that divalproex reduced both irritability and the risk of relapse to heavy drinking when compared with placebo.…”

Section: Anticonvulsants For the Treatment Of Harmful Drinking Pattmentioning

confidence: 99%

Anticonvulsants for the Treatment of Alcohol Withdrawal Syndrome and Alcohol Use Disorders

et al. 2015

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Alcoholic patients suffer from harmful allostatic neuroplastic changes in the brain causing an acute withdrawal syndrome upon cessation of drinking followed by a protracted abstinence syndrome and an increased risk of relapse to heavy drinking. Benzodiazepines have long been the treatment of choice for detoxifying patients and managing alcohol withdrawal syndrome (AWS). Non-benzodiazepine anticonvulsants (NBACs) are increasingly being used both for alcohol withdrawal management and for ongoing outpatient treatment of alcohol dependence, with the goal of either abstinence or harm reduction. This expert narrative review summarizes the scientific basis and clinical evidence supporting the use of NBACs in treating AWS and for reducing harmful drinking patterns. There is less evidence in support of NBAC therapy for AWS, with few placebo-controlled trials. Carbamazepine and gabapentin appear to be the most promising adjunctive treatments for AWS, and they may be useful as monotherapy in select cases, especially in outpatient settings and for the treatment of mild-to-moderate low-risk patients with the AWS. The body of evidence supporting the use of the NBACs for reducing harmful drinking in the outpatient setting is stronger. Topiramate appears to have a robust effect on reducing harmful drinking in alcoholics. Gabapentin is a potentially efficacious treatment for reducing the risk of relapse to harmful drinking patterns in outpatient management of alcoholism. Gabapentin's ease of use, rapid titration, good tolerability, and efficacy in both the withdrawal and chronic phases of treatment make it particularly appealing. In summary, several NBACs appear to be beneficial in treating AWS and alcohol use disorders.

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Section: Anticonvulsants For the Treatment Of Harmful Drinking Pattmentioning

confidence: 99%

Anticonvulsants for the Treatment of Alcohol Withdrawal Syndrome and Alcohol Use Disorders

et al. 2015

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“…However, in other clinical trials neither carbamazepine (Kranzler et al, 1995) nor divalproex, a valproate derivative (Brady et al, 2002) significantly altered alcohol intake in alcohol dependent subjects. Also, valproate has not been found to reduce the desire of alcoholic individuals to drink (Minuk et al, 1995). Thus, questions remain concerning the efficacy of older anticonvulsants as medications for the treatment of alcohol dependence.…”

Section: Introductionmentioning

confidence: 99%

Zonisamide decreases ethanol intake in rats and mice

Knapp

Mercado

Markley

et al. 2007

Pharmacology Biochemistry and Behavior

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Several anticonvulsant agents, including topiramate and valproate, have been found to reduce alcohol consumption in rodent models of drinking. The question of whether the novel anticonvulsant agent, zonisamide, shares similar actions in either mice or rats was investigated in the present experiments. In an initial experiment, the consumption of a 10% ethanol-5% sucrose solution, available for one hour, by Wistar rats treated with lactose, topiramate, or zonisamide was determined. In a second experiment, the intake of a 10% ethanol/water solution, accessible for two hours, by C57BL/B6N mice treated with either zonisamide or vehicle was assessed. In the rat, 50 mg/kg (PO) doses of either topiramate or zonisamide produced significant, but moderate decreases in ethanol/sucrose intake. The administration of a 50 mg/kg (IP) dose of zonisamide to mice resulted in a marked lowering in ethanol consumption. These results provide evidence that zonisamide administration will decrease ethanol consumption by both mice and rats in limited access models of drinking, and might, like topiramate, be useful as a medication for alcoholism.

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“…This observation is consistent not only with the evidence in favor of greater severity in this kind of patient (Maremmani et al, 2007b), but also with the higher rate of previous unsuccessful treatments (especially short-term methadone treatments) that has been recorded. Craving for alcohol and cocaine has, in fact, been found to be correlated with low or non-blocking methadone dosages in methadone-maintained patients (Stine et al, 1992; Tennant and Shannon, 1995; Foltin and Fischman, 1996; Lubrano et al, 2002). …”

Section: Discussionmentioning

confidence: 99%

Correlations Between Awareness of Illness (Insight) and History of Addiction in Heroin-Addicted Patients

Maremmani¹,

Rovai²,

Rugani³

et al. 2012

Front. Psychiatry

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In a group of 1066 heroin addicts, who were seeking treatment for opioid agonist treatment, we looked for differences in historical, demographic, and clinical characteristics, between patients with different levels of awareness of illness (insight). The results showed that, in the cohort studied, a majority of subjects lacked insight into their heroin-use behavior. Compared with the impaired-insight group, those who possessed insight into their illness showed significantly greater awareness of past social, somatic, and psychopathological impairments, and had a greater number of past treatment-seeking events for heroin addiction. In contrast with other psychiatric illnesses, the presence of awareness appears to be related to the passing of time and to the worsening of the illness. Methodologies to improve the insight of patients should, therefore, be targeted more directly on patients early in their history of heroin dependence, because the risk of lack of insight is greatest during this period.

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The Use of Sodium Valproate in the Treatment of Alcoholism

Cited by 17 publications

References 0 publications

Anticonvulsants for the Treatment of Alcohol Withdrawal Syndrome and Alcohol Use Disorders

Anticonvulsants for the Treatment of Alcohol Withdrawal Syndrome and Alcohol Use Disorders

Zonisamide decreases ethanol intake in rats and mice

Correlations Between Awareness of Illness (Insight) and History of Addiction in Heroin-Addicted Patients

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