The generic drug gabapentin, which is already widely prescribed for epilepsy and some kinds of pain, appears to be safe and effective in the treatment of alcohol dependence.
The finding comes from a 150-patient randomized, placebo-controlled, double blind clinical trial conducted by scientists at The Scripps Research Institute (TSRI).
“Gabapentin’s effect on drinking outcomes is at least as large or greater than those of existing FDA-approved treatments,” said Barbara J. Mason, Pearson Family Professor and co-director of the Pearson Center for Alcoholism and Addiction Research at TSRI, who led the new research. “Plus it’s the only medication shown to improve sleep and mood in people who are quitting or reducing their drinking, and it’s already widely used in primary care—that’s an appealing combination.”
The new research was published by the journal JAMA Internal Medicine on November 4, 2013.
Reducing Cravings, Depression, Sleeplessness
As a relatively safe, effective and well-tolerated drug, gabapentin has the potential to fill a large gap in the treatment of alcohol dependence. About eight and a half-million Americans are thought to have the condition, yet each year only a tiny fraction of them are prescribed one of the FDA-approved medications for alcohol dependence, due in part to the limitations of the existing drugs used for treatment.
The lack of treatment is striking in light of alcoholism’s enormous adverse impact on society. In addition to its other effects on the lives of individuals and their families, alcoholism promotes cancer, liver disease, strokes and heart attacks, as well as various other disabilities. Worldwide, about one out of 25 deaths is attributable to alcohol misuse.
In the new study, Mason and her colleagues randomly assigned each of 150 recently abstinent people with alcohol dependence to be treated with 900 mg or 1,800 mg of gabapentin or with a look-alike placebo. Over 12 weeks of treatment, the high-dose group ended up refraining from heavy drinking twice as often as the placebo group (45% vs. 23%) and entirely abstained four times as often (17% vs. 4%). The drug also significantly reduced the number of drinks consumed, as well as patient reports of cravings, depression and sleeplessness. None of the treated patients reported serious side effects.
Patients who received the lower, 900-mg dose of gabapentin showed intermediate benefits compared to the high-dose group, likely reflecting what clinicians call a “dose-response effect”—a good indication that the treatment really is working.
“I think that we can now have confidence in the pharmacological effect of this drug,” Mason said.