April 07, 2014
By David Martin
|Ann Manzardo, Ph.D.|
Women who took high doses of the vitamin thiamine drank less alcohol in a University of Kansas School of Medicine study of problem drinkers. The study used a manmade thiamine analogue called benfotiamine to achieve higher than normal thiamine doses.
Thiamine deficiency is common among people who abuse alcohol. Heavy drinking can lead to poor dietary habits, and alcohol interferes with the body's ability to absorb nutrients from the gut. Thiamine, also known as vitamin B1, is an essential nutrient that humans obtain from their diet. Enzymes use thiamine to perform numerous critical biochemical reactions in the body, including the brain. In severe cases, thiamine deficiency can lead to dementia and death.
The researchers at KU designed a study to test if people with drinking problems might benefit from taking a high potency thiamine supplement. "We know that thiamine deficiency causes big problems in alcoholics," Ann Manzardo, Ph.D., M.S.C.R., assistant professor of psychiatry and behavioral sciences and lead author of the study, says. "The underlying theory of the study was maybe if we improve neurological functioning and some of these neurological problems caused by thiamine deficiency, then alcoholics might make better decisions about their drinking and have greater control over their alcohol use."
The results in women supported the theory. Female participants who took benfotiamine reduced their drinking more than the participants who were given a placebo. They also reported fewer heavy drinking days than the participants who were part of the control group. "They continued to drink alcohol," Manzardo says of the women in the study. "They just didn't drink as much when they did drink. It suggests that they had a little more control over the behavior."
The change in behavior was rapid. The women taking the supplements decreased their consumption by 45 percent within one month of treatment. Manzardo believes that restoring their nutrition levels gave the women a quick boost in mood and emotional status. "We know thiamine deficiency can have negative effects on mood," she says.
With the men, there was no obvious difference in consumption levels between the control and treatment groups, but the most severely alcohol-dependent men did show significant improvements in some psychiatric symptoms with benfotiamine.
The study was published in the journal Drug and Alcohol Dependence.
Seventy men and women completed the six-month study. Manzardo and her colleagues found participants by placing a newspaper ad that asked: "Do you drink more alcohol than you should?" Participants who completed the study were eligible to receive up to $245 in gift cards.
Manzardo says the population "was extremely impaired." Many had been in and out of treatment facilities, jails or both. Some were homeless. "There was no mystery about the source of their problems," Manzardo says. The participants were not required to seek treatment or make a special effort to abstain, though they were referred to an outpatient clinic and a 12-step program.
At six months, alcohol consumption decreased among all groups: men and women, control and placebo. A behavioral response to study participation — also known as the placebo effect — is common in psychiatric studies. Still, the results suggest that thiamine supplements may be a useful part of an alcohol rehabilitation treatment plan, particularly early in treatment when chances for relapse are the highest, Manzardo says.
At the same time, Manzardo recognizes the limits of nutrition in treating alcoholism. All of the participants in the study continued to drink.
"I don't think anybody is trying to assert that we are going to cure alcoholism with a vitamin pill," she says. But she notes that thiamine is "something that's readily available and safe to use. It's something that's inexpensive and accessible to the population and would really benefit their overall health. Improving their physical health and mental functioning might provide that extra measure of resilience to fight the compulsion to drink again."
Other co-authors include Jianghua He, Ph.D., associate professor of biostatics; Albert Poje, Ph.D., assistant professor of psychiatry and behavioral sciences; Elizabeth Penick, Ph.D., professor of psychiatry and behavioral sciences; and Merlin Butler, M.D., Ph.D., professor of psychiatry and behavioral sciences.
The research was supported by a grant from the Hubert & Richard Hanlon Trust, National Institutes of Health General Clinical Research Center grant No. MO1RR023940 and Frontiers: The Heartland Institute for Clinical Translational Research grant No. UL1TR000001 (formerly No. UL1RR033179).