Epilepsy Drug Holds Promise as Treatment for Alcoholism

(HealthDay News) -- An drug used to treat epileptic seizures could be added to the short list of medications prescribed to help alcoholics control their addiction, a new study suggests.

The drug topiramate proved measurably better than a placebo at helping alcoholics stay away from heavy drinking, the study authors said.

"Not only is there an effective new treatment, but there's a medication that you can take at the time of crisis. You can start immediately when you need help," said study author Dr. Bankole Johnson, chairman of the University of Virginia's Department of Psychiatry and Neurobehavioral Sciences.

For many alcoholics, treatment is no different than it was 50 or 60 years ago: They must rely on their own willpower, often with the help of groups like Alcoholics Anonymous. But some -- about 3 percent to 4 percent, Johnson estimates -- try to quit drinking with the help of prescription medications.

In the new study, conducted between 2004 and 2006, Johnson and his colleagues recruited 371 alcoholics between the ages of 18 and 65. The subjects, both male and female, received daily doses of topiramate -- up to 300 milligrams -- or a placebo along with a brief weekly visit with a counselor.

Both treatments seemed to help patients. Over 14 weeks, the percentage of heavy-drinking days per week dropped from 81.9 percent to 43.8 percent among those who took topiramate and from 82 percent to 51.8 percent among those who took a placebo.

Topiramate also led to a higher rate of achieving 28 or more days of continuous non-heavy drinking and 28 or more days of continuous abstinence, the researchers said.

The drug appears to work by cutting the craving for alcohol, according to Johnson.
The findings are published in the Oct. 10 issue of the Journal of the American Medical Association.

There are side effects with topiramate, Johnson said. The drug "can make you dizzy, give you headaches and the feeling of pins and needles in your fingers. Some people have difficulty naming words, which goes away after about a week."

The drug isn't cheap -- it costs about $1,000 for three months, according to Johnson. And, patients don't see benefits for two to four weeks. Still, topiramate holds promise, he said.
"We're talking about a drug that will be many times better than what is currently available," he said. "And it doesn't require you to go to rehab."

Dr. J.C. Garbutt, professor of psychiatry at the University of North Carolina at Chapel Hill, said the new research on topiramate will give doctors another option when they treat alcoholism. Since the drug is already approved for use, doctors can prescribe it immediately.

Garbutt said it's still difficult for doctors to figure out which medication to prescribe to alcoholics. But "this gives you another one you can work with," he said.

Meanwhile, Johnson said, the next step is to study whether people can safely take topiramate for long periods of time.

Meanwhile, the group Public Citizen on Tuesday sent a letter to U.S. Food and Drug Administration Commissioner Andrew von Eschenbach claiming that a questionnaire that accompanied a press kit on the study violated FDA regulations that prohibit the promotion of the off-label use of a medication. Ortho-McNeil Janssen makes topiramate and funded the study.

More information
For more on alcoholism and treatment, visit the National Institute on Alcohol Abuse and Alcoholism.

Health Tip: Prevent Athlete's Foot

(HealthDay News) - Athlete's foot is a fungal infection, often found in public locker rooms and showers, or anywhere else that is damp, dark and warm.

Here are suggestions to help prevent athlete's foot, courtesy of the American Podiatric Medical Association:

• Don't walk barefoot in public areas like pools, showers, locker rooms or dressing rooms.
• Always wear flip flops or some kind of shower shoes.
• Before putting on shoes, sprinkle the feet with talcum powder to keep them dry.
• Wear shoes that allow air to circulate so that your feet stay drier.
• Wear thick, absorbent socks that keep your feet dry, and change them at least daily.

'Virtual' Colonoscopy an Effective Option: Study

(HealthDay News) -- A new study supports the effectiveness of an innovative form of colonoscopy that relies on a CT scanner that's sent through a patient's colon.

When it comes to detecting polyps that might become malignant, this so-called "virtual colonoscopy" is just as effective as the traditional approach of using a fiber-optic device, explained study lead Dr. David Kim, assistant professor of radiology at the University of Wisconsin.

The real advantage to the technology is that "it can do it in a less invasive manner for less cost and at less risk," he said.

According to the American Cancer Society, colorectal cancer is the third most common cancer in the United States among both men and women. It's especially common among people over the age of 50. An estimated 112,000 people in the United States will be diagnosed with the disease this year, and 52,000 will die.

Colonoscopies are considered essential to preventing the disease, but many people don't get them because of the cost or because of their reputation as being uncomfortable.

Virtual colonoscopies, by contrast, offer patients less discomfort, and Kim said could cost only one-third of the price.

Just as happens with the conventional test, patients using the virtual screen must still cleanse their bowels by using laxatives beforehand and have a catheter inserted into the rectum to expand their colon with carbon dioxide, Kim said.

However, unlike the traditional procedure, the patients aren't sedated, although Kim said they may feel "crampy" until the procedure is over.

CT scanners image the colons to look for signs of trouble. Doctors look at three-dimensional images on computers that "put you inside of the colon so you can navigate your way to look for polyps," Kim explained.

In the new study, Kim's team compared the effectiveness of traditional colonoscopies in 3,163 consecutive patients to virtual colonoscopies in 3,120 consecutive patients.

Reporting in the Oct. 4 issue of the New England Journal of Medicine, the researchers found that the two approaches were about equal in terms of detecting potentially dangerous polyps -- 123 were detected by virtual colonoscopy and 121 through the traditional approach. About eight percent of the patients who underwent the new approach had to return for traditional colonoscopies.

In the near future, doctors will need to screen patients using both approaches, he said. "The bottom line is that there's a huge number of people who should be screened but aren't -- 40 million people over age of 50 aren't screened. We're going to need both modalities to make an impact on this number."

Still, there are plenty of unanswered questions, said Dr. David Weinberg, director of gastroenterology at Fox Chase Cancer Center.

For one, he asked, "what does this do to overall colon cancer risk?" The study didn't look at that question, he said, and it's premature to declare that virtual colonoscopy should be a routine first-line screening test.

It's also unclear whether the new test is cost-effective or will be covered by insurance. Still, "it has potential to be useful because patients, when they know nothing about either, think they will prefer virtual colonoscopy," he said. That could lead to more of these potentially lifesaving screenings, Weinberg said.

But once they know the details -- particularly about how laxatives must still be used -- fewer people may think there's a huge difference between the two approaches, he said.

More information
For more about colorectal cancer screening options, visit the American Cancer Society.

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