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Topamax (topiramate)

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Topamax (topiramate) is an FDA approved anti-seizure medication that is prescribed off-label for the treatment of alcohol use disorders (AUDs). It is also used for the treatment of migraines and has been shown to be helpful with weight loss. It has not been widely studied as a treatment for AUDs. The fact that it has not been widely studied, and is prescribed off-label, means that physicians don't know about it. However, it may be more effective, particularly for people with certain genetic markers, than the medications that are FDA-approved. 

Topamax (topiramate) can be taken with naltrexone and campral. It should not be taken with baclofen. 

"Two trials suggested that topiramate [topamax] is also more efficacious than naltrexone, and one open-label study reported better results for disulfiram than for topiramate."1

"Topiramate, within the dosage range of 75-300mg/day, could be considered as a first line treatment option for the management of AUDs. It's use appears to be safe and well-tolerated, especially in light of very recent findings."2

"Topiramate treatment an be initiated while the alcohol-dependent individual is still drinking."3 There is a moderate interaction between topamax and alcohol which may increase the side effects of the medication. 

Though most studies find that topamax, particularly at low doses, is safe, there can be side effects. 

Side effects include:

  • Cognitive impairment
  • Mental slowing
  • Reduced verbal fluency
  • Memory issues
  • Dizziness
  • Weight loss
  • Can contribute to kidney stone formation
  • Rarely, the development of Acute Angle-closure Glaucoma (AACG) can result from topamax. It is serious and possibly irreversible. 

This information came directly from the book A Prescription for Alcoholics - Medications for Alcoholism written by Linda Burlison. Kindle location 5351-5396 and pages 321-340 in the book. There is a much more comprehensive explanation and further research available in the book. You can purchase it here: http://www.amazon.com/Prescription-Alcoholics-Medications-Alcoholism-ebook/dp/B01A1E8YKW/ref=sr_1_1?s=digital-text&ie=UTF8&qid=1456588006&sr=1-1&keywords=a+prescription+for+alcoholics

The website: http://www.aprescriptionforalcoholics.com/

1. Arbaizar B, Diersen-Sotos T, Gomex-Acebo I, Llorca J. Topiramate in the treatment of alcohol dependence: a meta-analysis. Actas Esp Psiquiatr. 2010; 38(1):8-12.

2. Guglielmo R, Martinotti G, Quatrale M, et al. Topiramate in Alcohol Use Disorders: Review and Update. CNS Drugs. 2015; 29(5):383-395. doi:10.1007/s40263-015-0244-0.

3. Johnson, B a, Ait-Daoud N. Topiramate in the new gneration of drugs: efficacy in the treatment of alcoholic patients. Curr Pharm Des. 2010;16(19):2013-2112. doi:10.2174/138161210791516404.

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