It seems your doctor must be up on the recent Lancet or Family Practice magazine, which both featured a small study on reduced cravings from Topamax (generic: topiramate). The study on Topamax for alcohol cravings stemmed from a report of Topomax helping the seizures of alcoholic withdrawal. Topmax is an anti-seizure, anti-epileptic drug with a range of side effects as long as your arm. It has only a short history of approval for seizures from the FDA, and my drug manual did not list alcohol withdrawal as an approved use of this medication. I have attached the Lancet study abstract, but I would get a full discussion of possible side effects from your doctor. I hope this helps,

Christopher Maloney, Naturopathic Doctor Manchester and Portland, Maine www.maloneymedical.com All posts are informational only, I cannot treat or diagnose via the web. Please consult your local physician or naturopathic doctor. If replying directly to me, please email me directly. (click my name above the post).

Lancet. 2003 May 17;361(9370):1677-85. Related Articles, Links

Comment in: J Fam Pract. 2003 Sep;52(9):682-3, 687. Lancet. 2003 May 17;361(9370):1666-7.

Oral topiramate for treatment of alcohol dependence: a randomised controlled trial.

Johnson BA, Ait-Daoud N, Bowden CL, DiClemente CC, Roache JD, Lawson K, Javors MA, Ma JZ.

Department of Psychiatry, University of Texas Health Science Center at San Antonio, TX 78229-3900, USA. bjohnson@uthscsa.edu

BACKGROUND: Topiramate, a sulphamate fructopyranose derivative, might antagonise alcohol\'s rewarding effects associated with abuse liability by inhibiting mesocorticolimbic dopamine release via the contemporaneous facilitation of gamma-amino-butyric acid activity and inhibition of glutamate function. We aimed to see whether topiramate was more effective than placebo as a treatment for alcohol dependence. METHODS: We did a double-blind randomised controlled 12-week clinical trial comparing oral topiramate and placebo for treatment of 150 individuals with alcohol dependence. Of these 150 individuals, 75 were assigned to receive topiramate (escalating dose of 25-300 mg per day) and 75 had placebo as an adjunct to weekly standardised medication compliance management. Primary efficacy variables were: self-reported drinking (drinks per day, drinks per drinking day, percentage of heavy drinking days, percentage of days abstinent) and plasma gamma-glutamyl transferase, an objective index of alcohol consumption. The secondary efficacy variable was self-reported craving. FINDINGS: At study end, participants on topiramate, compared with those on placebo, had 2.88 (95% CI -4.50 to -1.27) fewer drinks per day (p=0.0006), 3.10 (-4.88 to -1.31) fewer drinks per drinking day (p=0.0009), 27.6% fewer heavy drinking days (p=0.0003), 26.2% more days abstinent (p=0.0003), and a log plasma gamma-glutamyl transferase ratio of 0.07 (-0.11 to -0.02) less (p=0.0046). Topiramate-induced differences in craving were also significantly greater than those of placebo, of similar magnitude to the self-reported drinking changes, and highly correlated with them. INTERPRETATION: Topiramate (up to 300 mg per day) is more efficacious than placebo as an adjunct to standardised medication compliance management in treatment of alcohol dependence.

Publication Types: Clinical Trial Randomized Controlled Trial

PMID: 12767733 [PubMed - indexed for MEDLINE]