Harvard Mental Health Letter

In Brief: Topiramate may be effective at treating alcohol dependence

In Brief

Topiramate may be effective at treating alcohol dependence

Topiramate (Topamax) shows promise in helping people who are alcohol-dependent to cut back, according to the first large controlled study to evaluate it.

Researchers enrolled 371 men and women around the country. When the 14-week study began, the men all consumed at least 35 standard drinks per week; the women consumed at least 28. Neither participants nor researchers knew who was getting topiramate (up to 300 milligrams per day) or placebo pills. Brief weekly counseling sessions were given to enhance adherence.

The mean percentage of heavy-drinking days per month dropped from 82% at the start of the study for all participants to 44% at the end for those taking topiramate, compared with 52% for those taking placebo. The number of drinks consumed daily also fell, from an average of 11 drinks per day for all participants to an average of 6.5 per day for those on topiramate and 7.5 per day for those on placebo. About 15% of the people on topiramate had 28 days or more of continuous abstinence, compared with 3% of those taking placebo. Side effects of topiramate included abnormal skin sensations, changes in taste, loss of appetite, and difficulty concentrating.

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