Abstract: Objective To investigate the clinical efficacy and safety of escitalopram combined with topiramate on male alcohol dependence with anxiety and depression,and the effect on the rate of relapse. Methods A randomized, controlled clinical trial design was used to randomly divide patients into escitalopram combined with topiramate treatment group(co-administration group)and escitalopram treatment group(single-treatment group). The comcourse of treatment was 12 weeks.Before and after treatment, the Hamilton Depression Scale(HAMD), Hamilton Anxiety Scale(HAMA), Symptom Scale(TESS), Visual Analogue Scale(VAS), etc. were used to evaluate the clinical efficacy of patients and safety. Results The HAMA and HAMD scores of the two groups were significantly different at the 4th and 8th weekends after treatment compared with before treatment(P<0.05). With the extension of treatment, the VAS scores of the two groups gradually decreased, and the degree of craving for alcohol in co-administration group was more obvious.Compared with the single-treatment group, the difference was statistically significant(P<0.05). The re-drinking rate of the co-administration group was lower than that of the single-treatment group at 6 months of follow-up, and the difference was statistically significant(χ²=11.009, P=0.001<0.05). The difference in the incidence of adverse reactions between the two groups was not statistically significant(P>0.05). Conclusion For the alcohol-dependent patients with anxiety and depression, the effect between esitalopram combined with topiramate and esitalopram alone treating anxiety and depression have no statistical difference, but the effect decreasing thirst for alcohol of esitalopram combined with topiramate is better than esitalopram alone, and the patients of esitalopram combined with topiramate have a lower rate of recidivism. The adverse effects of the two treatments are comparable.

Key words: alcohol dependence, topiramate, escitalopram, anxiety, depression, relapse rate