University of Virginia Health System

Topiramate is a medication that is currently being tested for alcohol dependence and other drug addictions. It is also known as TOPAMAX and is manufactured by Ortho-McNeil Pharmaceuticals, Inc. It appears to block the rewarding effect of alcohol on your brain, and therefore reduces the craving for alcohol or other drugs.

Topiramate is not FDA approved for alcohol or drug dependence at this time. It is currently approved as a seizure medication and also as a migraine preventative.

Currently we are conducting clinical trials for alcohol dependence and cocaine dependence at the University of Virginia in Charlottesville, VA and in Richmond, VA.

The medication is slowly titrated up to a maximum dose of 300 mg/day, but this is not right for all people. For the best information, please speak with your primary care provider about what dose of topiramate is right for you.

Common side effects are tingling in arms and legs, loss of appetite, nausea, diarrhea, taste change, and weight loss. Serious risks associated with topiramate include lowered bicarbonate levels in the blood resulting in an increase in the acidity of the blood (metabolic acidosis), and hyperventilation (rapid, deep breathing) or fatigue. Other serious risks include increased eye pressure (glaucoma), decreased sweating, increased body temperature, kidney stones, sleepiness, dizziness, confusion and difficulty concentrating. It is important to tell your doctor what other medications you are taking and also to talk to them about whether or not this medication would be right for you.

Currently on the market there are 3 medications for alcohol dependence. Naltrexone (ReVia), Antabuse, and Acamprosate (Campral).