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Adding to the Continuum of Care

Mark L. Willenbring, MD

JAMA. 2007;298:1691-1692.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The most prevalent form of treatment for alcohol dependence in the United States is group counseling and referral to community support groups, a treatment that was developed more than 30 years ago.¹ At that time, the only medication available to prevent relapse was disulfiram, which has limited efficacy and patient acceptability. Since that time, acamprosate and naltrexone have been approved for the treatment of alcohol dependence, the latter in both oral and long-acting injectible forms. However, few physicians prescribe these drugs, and most treatment programs do not use them.²

In this issue of JAMA, Johnson and colleagues³ report on a large multisite trial of topiramate, a drug with complex actions including activity at -aminobutyric acid and glutamate receptors. Replicating the results of a smaller randomized controlled trial,⁴ topiramate produced significant and meaningful improvement in a wide variety of drinking outcomes. At the end of the . . . [Full Text of this Article]

Author Affiliation: National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland.

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