Benfotiamine Alcohol Use Disorder Study

Chronic alcohol use is strongly associated with nutritional deficiencies, particularly thiamine (vitamin B1) deficiency. Severe thiamine deficiency can lead to Wernicke–Korsakoff syndrome, a neurological condition involving confusion, memory impairment, and loss of coordination. One of the early signs of low thiamine levels can be depression.

Benfotiamine is a fat-soluble synthetic derivative of thiamine. It has been licensed in Germany since 1993 under the trade name Milgamma and is often prescribed there for sciatica and other painful nerve-related conditions.

A study published in Drug and Alcohol Dependence (July 2015;152:257–263) examined whether benfotiamine could improve psychiatric symptoms in individuals with alcohol use disorder.

Study Overview

  • Participants: 85 adult men (average age ~48) diagnosed with current alcohol use disorder

  • Design: Double-blind, randomized, placebo-controlled trial

  • Intervention:

    • Benfotiamine: 600 mg per day

    • Placebo: matched control

  • Duration: 6 months

  • Preparation: All subjects underwent 30 days of alcohol abstinence before starting the trial

  • Psychological assessments included:

    • Lifetime Alcoholism Severity Score (AS)

    • Symptom Checklist 90-R (SCL-90R)

    • Barratt Impulsivity Scale (BIS)

These tools measured psychiatric distress, impulsivity, and symptom severity at baseline and again after six months of treatment.

Educational only — not medical advice.  

Key Results After Six Months

  • Among subjects with high lifetime alcoholism severity (AS ≥ 24), men treated with benfotiamine showed significant reductions in psychiatric distress (as measured by the SCL-90R) compared with placebo.

  • A statistical model (MANOVA) revealed a significant treatment effect (F = 2.5, df = 10, p < 0.03) and a treatment × alcoholism severity interaction (F = 2.5, p < 0.03), indicating that benfotiamine’s beneficial effects were most pronounced in those with more severe AUD.

  • In a subset of participants with elevated plasma thiamine levels at follow-up, there was a trend toward reduced depression scores (p < 0.09).

  • The study concluded that benfotiamine “appears to reduce psychiatric distress and may facilitate recovery in severely affected males with a lifetime alcohol use disorder.”

No serious adverse events were reported, and the supplement was generally well tolerated.

Broader Context & Related Findings

Previous clinical trials and observational reports have noted that benfotiamine may improve neurological complications of chronic alcoholism. For example, benfotiamine has shown benefits for alcoholic polyneuropathy, improving vibration perception and motor function over an 8-week randomized trial. 
Its enhanced bioavailability compared with regular thiamine allows more efficient restoration of thiamine-dependent enzymatic activity in deficient individuals. ScienceDirect+1

Given the known risk of thiamine deficiency in heavy drinkers — and the role of thiamine in brain energy metabolism and neurological health — supplementing with benfotiamine may help mitigate some neuropsychiatric and neuropathic effects of chronic alcohol use. OUP Academic+2Alcohol and Drug Foundation+2

Important Notes 

  • The 2015 trial involved only men, so results may not generalize to women.

  • Benefit was most evident in those with high severity of alcoholism (AS ≥ 24); individuals with lower severity showed less consistent effect.

  • The reduction in depressive symptoms was not uniformly robust across all participants. The trend toward reduced depression in the plasma-thiamine–elevated subgroup did not reach strong statistical significance (p < 0.09) in all measured domains.

  • As with many nutrition-based interventions, long-term randomized data remain limited. More research would help clarify optimal dosing, duration, and patient selection criteria.

Conclusion

The 2015 Drug and Alcohol Dependence trial provides preliminary evidence that benfotiamine supplementation (600 mg/day) may help reduce psychiatric distress in men with long-standing alcohol use disorder — especially those with severe disease history. Combined with benfotiamine’s favorable tolerability and established benefit in alcoholic neuropathy, these findings support further investigation.