Nearly 14 million Americans meet the diagnostic criteria for alcohol abuse or alcoholism. Alcohol problems, alone or in combination with illicit drug problems, account for 40 percent of admissions to addiction treatment programs each year, according to the federal Substance Abuse and Mental Health Services Administration.

"There may be some underlying chemical changes in the brain that prompt alcoholics to report more insomnia as a co-existing condition than non-alcoholics," she says. "A possible explanation of these new findings is that the gabapentin might decrease the insomnia initially, and the patient may not need or crave alcohol as a treatment for the insomnia. We're also looking into other factors that may have an effect on the neurochemistry of the brain, and see how they could impact recovery and sleep."

The researchers caution that they did not observe differences in brain wave data collected during sleep studies conducted before and after patients received gabapentin. Neither did the drug appear to have a greater benefit for insomnia than placebo during the first 6 weeks of receiving study medication. Six weeks after stopping medication, however, those who had taken gabapentin reported worse insomina than those on placebo. Insomnia was measured using standardized questionnaires for a total of 12 weeks.

All of the volunteers met national criteria for alcohol dependence, and were either in alcohol treatment or expressed a willingness to abstain from alcohol. They also all met criteria for insomnia that had lasted six months or more. They could not have other medical or mental health conditions, or be taking medications that might affect their sleep, and underwent blood tests to rule out medical illnesses such as thyroid deficiency and liver disease.

Each of the study volunteers spent three nights in the U-M Sleep Disorders Center: two during the preparation for the study, and one three weeks after they began to receive gabapentin or placebo. All the volunteers received up to six brief sessions of behavioral therapy aimed not at sleep or alcohol issues, but rather at adherence to the study medication.

Fourteen of the volunteers successfully completed the entire study, including a follow-up appointment six weeks after they completed the six-week course of gabapentin or placebo, and three overnight sleep studies.

Brower notes that the medication dose and schedule used in the study may have contributed to the relatively weak effect on sleep that was seen from gabapentin. Patients took one dose each evening, rather than the three doses throughout the day that are routinely given for epilepsy or pain.

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