Benfotiamine for Alcoholism: Can Vitamin B1 Help?

cohort-study PMID: 25908323

Quick Summary: A study found that a special form of Vitamin B1, called benfotiamine, may help reduce psychiatric symptoms like anxiety and depression in men with severe alcoholism. This was especially true for those with a history of heavy drinking.

What The Research Found

Researchers looked at men with alcohol use disorder. They found that benfotiamine helped reduce symptoms of psychiatric distress, like feeling anxious or depressed, in men who had a history of severe alcoholism. The men with more severe alcoholism also had more psychiatric symptoms at the start of the study. The study also suggested that higher levels of Vitamin B1 in the blood were linked to fewer symptoms of depression in those taking benfotiamine.

Study Details

Who was studied: 85 adult men with alcohol use disorder. All the men had stopped drinking for less than a month when the study started.

How long: The study lasted for 6 months.

What they took: Half the men took 600mg of benfotiamine daily, and the other half took a placebo (a sugar pill).

What This Means For You

If you are a man with a history of severe alcoholism, benfotiamine might help reduce symptoms of anxiety and depression as part of a treatment plan. However, it's important to talk to your doctor before taking benfotiamine. This study doesn't mean that benfotiamine is a cure for alcoholism, but it could be a helpful part of a recovery program.

Study Limitations

The study only included men, so we don't know if it would have the same effect on women.

A lot of people dropped out of the study, which could affect the results.

The study focused on men with severe alcoholism, so it may not apply to people with less severe drinking problems.

The study did not measure the participants' diet or other nutrient deficiencies.

Key Findings

Benfotiamine (BF) significantly reduced psychiatric distress in males with severe lifetime alcoholism (alcoholism severity score ≥24), but not in those with lower severity. High-alcoholism-severity (HAS) males had significantly worse baseline psychiatric symptoms (SCL-90R) than low-severity (LAS) males. A significant treatment-by-severity interaction (F=2.5, dfnum=10, dfden=30, p<0.03) showed BF specifically lowered SCL-90R scores in HAS males. In a BF-treated subset (n=26), above-normal plasma thiamine levels at follow-up predicted reduced depression scores (F=3.2, p<0.09). BF did not affect impulsivity (BIS scores).

Study Design

This was a 6-month randomized, double-blind, placebo-controlled trial (RCT) registered as NCT00680121. It involved 85 adult males (mean age 48±8 years) meeting DSM-IV-TR criteria for current alcohol use disorder, all abstinent for <30 days at baseline. Participants were stratified by alcoholism severity (AS≥24 = HAS, n=46; AS<24 = LAS, n=39). Analysis focused on completers (n=50: 25 BF, 25 placebo).

Dosage & Administration

Participants received 600 mg of benfotiamine (BF) or placebo daily for 6 months. BF is a high-bioavailability thiamine prodrug analog, administered orally.

Results & Efficacy

MANOVA revealed a significant main treatment effect on SCL-90R scores (F=2.5, df=10, p<0.03) and a significant treatment×alcoholism severity interaction (F=2.5, dfnum=10, dfden=30, p<0.03), confirming BF specifically reduced psychiatric symptomatology in HAS males. Baseline SCL-90R scores were significantly higher in HAS vs. LAS males (p<0.05, exact p not provided). In the BF-treated subgroup with plasma thiamine data (n=26), elevated thiamine levels correlated with reduced depression scores (F=3.2, p<0.09), though this did not reach conventional significance (p<0.05).

Limitations

The high dropout rate (41.2%, 35/85) limits generalizability and statistical power. The analysis relied on completers (n=50), introducing potential attrition bias. The study exclusively enrolled males, so findings cannot be extrapolated to females. The alcoholism severity cutoff (AS=24) lacked external validation. The depression-thiamine correlation (p=0.09) was borderline significant. No data on dietary thiamine intake or concurrent nutrient deficiencies were provided.

Clinical Relevance

Benfotiamine (600 mg/day) may serve as an adjuvant therapy to reduce psychiatric symptoms specifically in males with severe, chronic alcohol use disorder during early abstinence. It is not indicated for mild/moderate cases or as a standalone treatment. Users should note BF is a pharmaceutical analog distinct from standard thiamine supplements and requires medical supervision in alcohol recovery contexts. This supports targeted thiamine repletion in severe alcoholism but does not apply to general population supplementation for mental health.