Abstract
Background: Previously, our group has shown that topiramate, a sulfamate-substituted fructopyranose derivative, is an effective treatment for alcohol dependence. Herein, we extend that proof-of-concept study by determining whether cigarette-smoking, alcohol-dependent individuals from the earlier study also experienced improved smoking outcomes. Methods: As a subgroup analysis of a larger double-blind, randomized, controlled, 12-week study comparing topiramate vs placebo as treatment for alcohol dependence, a 12-week clinical trial compared topiramate vs placebo in 94 cigarette-smoking, alcohol-dependent individuals. Of these, 45 were assigned to receive topiramate (escalating dose from 25 to 300 mg/d) and the remaining 49 had placebo as an adjunct to weekly standardized medication compliancemanagement.Theprimaryoutcomewassmoking cessation ascertained by self-report and confirmed by the level of serum cotinine (nicotine's major metabolite). Results: Topiramate recipients were significantly more likely than placebo recipients to abstain from smoking (odds ratio, 4.46; 95% confidence interval, 1.08-18.39; P=.04). Using a serum cotinine level of 28 ng/mL or lower to segregate nonsmokers from smokers, we found that the topiramate group had 4.97 times the odds of being nonsmokers (95% confidence interval, 1.1-23.4; P=.04). Smoking cessation rates for topiramate recipients were 19.4% and 16.7% at weeks 9 and 12, respectively, compared with 6.9% at both time points for placebo recipients. Conclusion: In this trial, topiramate (up to 300 mg/d) showed potential as a safe and promising medication for the treatment of cigarette smoking in alcohol-dependent individuals.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1600-1605 |
| Number of pages | 6 |
| Journal | Archives of Internal Medicine |
| Volume | 165 |
| Issue number | 14 |
| DOIs | |
| State | Published - Jul 25 2005 |
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ASJC Scopus subject areas
- Internal Medicine
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Use of oral topiramate to promote smoking abstinence among alcohol-dependent smokers a randomized controlled trial. / Johnson, Bankole A.; Ait-Daoud, Nassima; Akhtar, Fatema Z.; Javors, Martin A.
In: Archives of Internal Medicine, Vol. 165, No. 14, 25.07.2005, p. 1600-1605.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Use of oral topiramate to promote smoking abstinence among alcohol-dependent smokers a randomized controlled trial
AU - Johnson, Bankole A.
AU - Ait-Daoud, Nassima
AU - Akhtar, Fatema Z.
AU - Javors, Martin A
PY - 2005/7/25
Y1 - 2005/7/25
N2 - Background: Previously, our group has shown that topiramate, a sulfamate-substituted fructopyranose derivative, is an effective treatment for alcohol dependence. Herein, we extend that proof-of-concept study by determining whether cigarette-smoking, alcohol-dependent individuals from the earlier study also experienced improved smoking outcomes. Methods: As a subgroup analysis of a larger double-blind, randomized, controlled, 12-week study comparing topiramate vs placebo as treatment for alcohol dependence, a 12-week clinical trial compared topiramate vs placebo in 94 cigarette-smoking, alcohol-dependent individuals. Of these, 45 were assigned to receive topiramate (escalating dose from 25 to 300 mg/d) and the remaining 49 had placebo as an adjunct to weekly standardized medication compliancemanagement.Theprimaryoutcomewassmoking cessation ascertained by self-report and confirmed by the level of serum cotinine (nicotine's major metabolite). Results: Topiramate recipients were significantly more likely than placebo recipients to abstain from smoking (odds ratio, 4.46; 95% confidence interval, 1.08-18.39; P=.04). Using a serum cotinine level of 28 ng/mL or lower to segregate nonsmokers from smokers, we found that the topiramate group had 4.97 times the odds of being nonsmokers (95% confidence interval, 1.1-23.4; P=.04). Smoking cessation rates for topiramate recipients were 19.4% and 16.7% at weeks 9 and 12, respectively, compared with 6.9% at both time points for placebo recipients. Conclusion: In this trial, topiramate (up to 300 mg/d) showed potential as a safe and promising medication for the treatment of cigarette smoking in alcohol-dependent individuals.
AB - Background: Previously, our group has shown that topiramate, a sulfamate-substituted fructopyranose derivative, is an effective treatment for alcohol dependence. Herein, we extend that proof-of-concept study by determining whether cigarette-smoking, alcohol-dependent individuals from the earlier study also experienced improved smoking outcomes. Methods: As a subgroup analysis of a larger double-blind, randomized, controlled, 12-week study comparing topiramate vs placebo as treatment for alcohol dependence, a 12-week clinical trial compared topiramate vs placebo in 94 cigarette-smoking, alcohol-dependent individuals. Of these, 45 were assigned to receive topiramate (escalating dose from 25 to 300 mg/d) and the remaining 49 had placebo as an adjunct to weekly standardized medication compliancemanagement.Theprimaryoutcomewassmoking cessation ascertained by self-report and confirmed by the level of serum cotinine (nicotine's major metabolite). Results: Topiramate recipients were significantly more likely than placebo recipients to abstain from smoking (odds ratio, 4.46; 95% confidence interval, 1.08-18.39; P=.04). Using a serum cotinine level of 28 ng/mL or lower to segregate nonsmokers from smokers, we found that the topiramate group had 4.97 times the odds of being nonsmokers (95% confidence interval, 1.1-23.4; P=.04). Smoking cessation rates for topiramate recipients were 19.4% and 16.7% at weeks 9 and 12, respectively, compared with 6.9% at both time points for placebo recipients. Conclusion: In this trial, topiramate (up to 300 mg/d) showed potential as a safe and promising medication for the treatment of cigarette smoking in alcohol-dependent individuals.
UR - http://www.scopus.com/inward/record.url?scp=23744482491&partnerID=8YFLogxK
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U2 - 10.1001/archinte.165.14.1600
DO - 10.1001/archinte.165.14.1600
M3 - Article
C2 - 16043677
AN - SCOPUS:23744482491
VL - 165
SP - 1600
EP - 1605
JO - JAMA Internal Medicine
JF - JAMA Internal Medicine
SN - 2168-6106
IS - 14
ER -