A study was just published in the New England Journal of Medicine linking the drug Topomax, which is used to treat migraines - as in I use it to help with my migraines - to reduced drinking in Alcoholics. Apparently, in a 14 week study, 15% of the people who didn’t drop out had quit drinking entirely in seven weeks.

Since this was not a long term study there’s no information to tell whether people started drinking again or whether it had any sort of lasting effect. But that’s a pretty significant number if you ask me.

To think about being able to treat alcoholism is amazing. Alcoholics fight to have alcoholism recognized as a disease, not as a condition. Sort of like what depression was before it was treatable. There was a stigma around suffering from “depression.” Talk therapy was your only outlet unless you were institutionalized. And institutionalization was only recommended for the most serious cases. For light cases of depression it either didn’t exist, or people saw “analysts.” Or “therapists” as we later called them.

And then came along…Prozac. And Lexapro. And Welbutrin. And so many variations of all of them that now we can’t count them all.

So to think that perhaps Topomax, or really a variation of it, could be a drug that people take daily in order to prevent them from suffering Alcoholism is monumental. So they tweak Topomax to the point where it actually works in a large population of the study and it becomes something that your general practitioner can prescribe for anyone who is embarrassed to admit to others that they are suffering from the disease. The number of alcoholics who want help but can’t find it dramatically increases.

So what’s the catch? The drug company that holds the patent for Topomax loses its patent in a year. Meaning it becomes a generic brand too soon for them to care to do studies in order to profit from the benefit of other uses for the drug. So using Topomax for treating Alcoholism as it currently exists is “off-label.” And to try to do further studies would cost money they don’t have interest in spending. And only further testing would show whether larger doses or different dosing or slightly tweaking or any sort of change of the drug would help increase the population of people for whom the drug would work.

So there go the big pharmaceutical companies for you. When the patent wears off the companies lose interest in the drug. Even if hope remains.

An interesting example of this in action is the drug Provigil. The drug has been around forever. It was used for people with narcolepsy and basically written off as a non-money making drug for the life of the patent. Then, in the last couple of years, doctors discovered the magic of Provigil. It worked in patients who were taking medications that made them lethargic yet it wasn’t an amphetamine and wasn’t addictive. Shift workers who worked all night could take it and it would help them work through the night against the desire to sleep. Members of the armed forces could take it in combat situations to keep them alert. There were suddenly a multitude of uses for the drug as it helped keep people alert, but it was not an amphetamine, wasn’t addictive, and didn’t have the jittery side effects of your average wakefulness promoting agents. So what did the drug company do? With two years left on the patent they jacked up the price to $10 a pill and now insurance companies are reticent to cover the cost of the prescription. I have a friend who is narcoleptic: her insurance company provides 2 pills per month. Great for the 2 days per month that she’s driving and happens to have a Provigil. What about the other 28 days?

That’s the magic of a patent. And of pharmaceutical companies. And of insurance. Which is why I talked to Bill Clinton about Hillary’s health care plan. Because what we have now definitely isn’t working.

• BROWSE / IN TIMELINE
• « Have You Ever Missed A Flight?
• » I’m Always Oversleeping

• BROWSE / IN Health