Click This Link

• A study led by Dr. Bankole Johnson of the University of Virginia found that topiramate (Topamax) -- already used to treat epilepsy and migraines -- reduced the number of days on which alcoholics drank heavily, by 25 percent more than among alcoholics who got just therapy.

• A federally funded study known as COMBINE compared cognitive-behavioral therapy alone with therapy along with naltrexone. Patients receiving both were more likely to stay abstinent and drank less if they did relapse.

These findings highlight what's become increasingly clear: Addiction is a brain disease, not just a failure of willpower. Naltrexone and topiramate have slightly different mechanisms, but both seem to block the release of brain chemicals that are linked to pleasure and excitement. Unlike earlier drugs used to treat alcoholics, neither is addictive or carries significant side effects. It does appear that each might work better in certain subgroups -- topiramate for repeat relapsers, and naltrexone in people with a strong family history of alcoholism. Interactive: Addiction's lure to the brain »

Johnson is a paid consultant to the company that makes Topamax, but his study appeared in the Journal of the American Medical Association and he says other medications can also work well. "I think everybody who's an alcoholic should be given medication if they're willing to take it," he says. "It's been shown over and over with research studies that effects of medicine are over and above that of therapy. And if you're not getting the medicine, it's a bit like having one hand tied behind your back."


medication is slowly creeping into mainstream addiction therapy. One big advocate is Percy Menzies, a pharmacist and former sales representative for DuPont, which developed naltrexone. His St. Louis, Missouri-based Recovery Centers for America treats patients in an on-site hospital, then refers them to outside physicians for follow-up treatment. Along with therapy, virtually every patient is given Vivitrol, a long-lasting form of naltrexone that's given monthly by injection.

Kent says naltrexone saved his life. When the COMBINE program was over, Kent's doctor told him to call if he felt the old need for a drink coming back. But it never came. "I have yet to go back and say, 'I have an urge for a drink,' " says Kent, lounging in Goober's. "[My friends] will offer, 'You want a drink?' And I say, 'No, I'm fine. I'll have a soda.' I'm fine with that. Because when there's no urge, no craving, it doesn't bother me. I'm living proof this can