"COMPARATIVE STUDY OF THE EFFECT OF TOPIRAMATE, DISULFIRAM, AND STANDARD ABSTINENCE ON SEXUAL FUNCTIONING OF MALES WITH ALCOHOL DEPENDENCE SYNDROME IN A TERTIARY CARE HOSPITAL SETUP: A RANDOMISED CONTROL TRIAL"

Abstract

Background: Sexual dysfunction and alcohol dependence often coexist, significantly impairing recovery and quality of life in males with Alcohol Dependence Syndrome (ADS). Pharmacological agents like Topiramate and Disulfiram are widely used for relapse prevention, yet their comparative effects on sexual functioning remain underexplored. Methods: This randomized controlled trial was conducted over 6 months at Saveetha Medical College and Hospital with 60 male participants diagnosed with ADS per ICD-10 criteria. Participants were randomly allocated into three groups (n = 20 each): Topiramate, Disulfiram, and standard abstinence with psychosocial support. Sexual functioning was assessed using the International Index of Erectile Function (IIEF-15) and Arizona Sexual Experiences Scale (ASEX), while alcohol dependence severity was assessed using the Severity of Alcohol Dependence Questionnaire (SADQ) at baseline, 4 weeks, and 12 weeks. Data were analyzed using paired t-tests and ANOVA for between-group comparisons. Results

• Topiramate group showed statistically significant improvement across all three scales:
  • IIEF (p = 0.03), ASEX (p = 0.042), and SADQ (p = 0.0001).
• Disulfiram group showed moderate improvement in all domains:
  • IIEF (p = 0.04), ASEX (p = 0.049), and SADQ (p = 0.01).
• Abstinence group showed no significant improvement:
  • IIEF (p = 0.08), ASEX (p = 0.095), SADQ (p = 0.082).

Conclusion: Topiramate demonstrated superior efficacy in improving sexual functioning and reducing alcohol dependence severity compared to Disulfiram and abstinence. It may be considered a preferred pharmacological option in ADS patients, particularly those with sexual dysfunction.