Topiramate for Alcohol Reduction

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My husband suffers from migraine quite badly. He has double vision, nausea, muddled thinking and various other symptoms with the migraine.

He knows that red wine, cheese and particularly chocolate are trigger foods, so obviously tries to avoid them.

He was reading about the drug Topiramate for treating migraines, not that he wanted to try it, but it was a drug he'd not heard of before. Whilst researching Topiramate, he came across an article on how successful Topiramate was in reducing cravings in AUD sufferers, based on trials in the USA.

There were claims that in these trials, Topiramate was found to be more effective than Acamposate (Campral). I was curious to see if anyone had taken this drug for AUD. From my cursory reading, it seemed to have a lot of side effects and not a drug I'd want to take.

Any comments on its success, or any views on its effectiveness for treating AUD would be interesting

 

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2 Replies

  • Posted

    As you are aware, it is used for migraines and epilepsy and would be off lable for alcohol.

    It is not a simple drug to take (for AUD) a bit like baclofen. As an example, you can give someone Campral who is pretty much an idiot and they can follow the instructions and little if any damage can be done. Nalmefene/naltrexone needs a little bit more common sense and I often read one of Joanna's posts, explaining that it isn't working, because they are not using it correctly. It isn't hard, just someone people don't listen or are incorrectly advised on how to use it.

    If I were to try something else other than the above drugs, I would go for baclofen, which is off label. But has to be taken in a very specific way, and titrate up to very large quantities to begin with (then taper down) and no doctor in the UK will prescribe that quantity. So you would be purchasing it privately. But it does work and has little side effects, IF done correctly.

    Topamax (brand name) follows a similar pattern, but is even less well known. You can need to titrate up to 300/400mg a day. I imagine your husband would start on 25mg a day and then titrate up to 50-100mg per day.

    The main side effects are cognitive impairment, reduced verbal fluency and memory issues. These all appear to be temporary. The one I am sure that he read, is the possibility of irreversible eye damage, AACG.

    There is a book by Roberta Jewel called My Way Out and there is a forum, Google My Way Out Topamax. There is also a Lancet study on it, but it is a pay article. I did research it last year, so this is from memory, it does seem to work, but has limited research, it has the side effects mentioned, so on balance I personally would avoid it (for off label use).

    Baclofen would be my choice over Topamax anyday. It too has some side effects, but it has been well researched and in at least France (maybe more now) it is on label for AUD.

    • Posted

      I guessed if anyone knew anything you would!! I wouldn't even consider anything other than campral.

      I've no intention of repeating my alcohol nightmare again.

      I knew about bacloven, but not heard of topamax. I've never considered naltrexone or nalmefene. If it stops the buzz you get from alcohol, then it's a non starter for me.

      I'm not knocking TSM, it seems to have helped many, but not for me.

      Thanks for the information though. Learn something new every day

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