Effects of Zonisamide in the Treatment of Alcohol Dependence

Objective: Anticonvulsant drugs have been used in the treatment of alcohol dependence. The purpose of the present study was to evaluate tolerance and safety of zonisamide in a sample of patients presenting alcohol dependence. Methods: Open-label zonisamide was examined in 22 outpatients with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition alcohol dependence. Zonisamide was started at a dose of 50 mg/d and titrated to a maximun dose of 300 mg/d. Subjects received a baseline evaluation including Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition and the Severity of Alcohol Dependence Scale. Alcohol craving and alcohol consumption were assessed at weeks 2, 4, 6, 8, 10, and 12. The concentration of gamma-glutamyltransferase was used as an indirect measure of alcohol consumption. Results: Significant improvement was observed in visual analog scale for craving severity scores, weekly drink consumption, and gamma-glutamyltransferase. Zonisamide was well tolerated, with only a dropout due to adverse events. Conclusions: Zonisamide is safe and well tolerated in this sample and associated with improvement in alcohol craving and alcohol consumption. A placebo-controlled study would be of interest.