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In Reply: In response to Drs Spaeth and Mantravadi, the efficacy of topiramate in treating alcoholism in our study compared favorably against the generally mild to moderate adverse events that participants encountered. No incidence of secondary angle-closure glaucoma was reported in either this study or the other topiramate study we conducted¹; however, we do agree that patients should be advised of this rare but serious adverse effect.

In response to Dr Ameisen, although comorbid symptoms of mood and anxiety disorder can occur in alcohol-dependent individuals, the frequency varies considerably among studies due to differences in population, demography, treatment history, and disease stage and duration.^2-3 Some alcohol-dependent individuals with symptoms of mood and anxiety that did not meet DSM-IV diagnostic criteria for a concomitant Axis I disorder were included in this trial. We agree that studies are needed to determine the efficacy of topiramate, perhaps in combination with other medications, . . . [Full Text of this Article]

Bankole A. Johnson, DSc, MD, PhD
bankolejohnson@virginia.edu

Nassima Ait-Daoud, MD
Department of Psychiatry and Neurobehavioral Sciences
University of Virginia
Charlottesville

Raymond F. Anton, MD
Department of Psychiatry and Behavioral Sciences
Medical University of South Carolina
Charleston

Domenic A. Ciraulo, MD
Division of Psychiatry
Boston University
Boston, Massachusetts

Henry R. Kranzler, MD
Department of Psychiatry
University of Connecticut
Farmington

Karl Mann, MD
Department of Addictive Behavior and Addiction Medicine
Central Institute of Mental Health, Mannheim
University of Heidelberg
Mannheim, Germany

Stephanie S. O’Malley, PhD
Department of Psychiatry
Yale University
New Haven, Connecticut

Robert M. Swift, MD, PhD
Department of Psychiatry and Human Behavior
Brown University
Providence, Rhode Island

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