Topomax & Lessened Alcohol Cravings
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Q:  I understand that Topamax can be used to lessen the craving for alcohol.  Is this true? 

Dear Ms. W' -- 
I've heard this is true.  Let's look at the published research on this: 
PUB MED, enter "topiramate alcohol", and we get, well, a bunch of stuff, including one study that was designed to answer this very question, with a large sample size (that helps insure the study won't miss an effect that's really there) and of course, gotta have this to answer your question, a placebo group.Johnson  

The main result: 

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).

What does that mean?  It means, as you can probably tell digging around in that sentence, that the people who got the real topiramate, compared to those who got a placebo and thought they might be getting topiramate:  drank less often and drank less when they did drink.  The thing about "plasma gamma-glutamyl transferase" means that their liver (enzymes) agreed with their personal report of their drinking.  

Now, just to be cautious, this study was probably funded by the manufacturer of Topomax.  So, there are subtle ways that can affect the results, but based on the abstract (click Johnson, above), I don't see too much evidence of the kind of skew one can see sometimes when it's a company making hay out of a weak study.  

So, that's the long way to answer your question -- hopefully showing you and others that, while I'm happy to learn along with you, you can also ask these kinds of questions and use your own literature search on PUB MED to get some idea of whether it's been examined by a research study, and perhaps even try to interpret the data as reported above.  Thanks for asking. 

Dr. Phelps

Published April, 2004


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