Possible Interaction: Ethanol and Topiramate

“This is because the principal neurochemical effects of topiramate would not only serve to decrease the acute reinforcing effects of alcohol or cocaine, but might also facilitate cessation of their use following a period of long-term use by decreasing neuronal sensitisation.”

“This preliminary study provides evidence that topiramate ’s attenuation of alcohol cue-elicited brain activation and craving are key elements of the drug’s neurobiological mechanism of action in reducing heavy drinking.”

“ Topiramate , relative to placebo, reduced alcohol cue-elicited activation of the left VS, bilateral OFC, and medial OFC, alcohol cue-elicited craving, and HDDs between baseline and 6 weeks of treatment.”

“Through these mechanisms of action, topiramate may reduce alcohol and cocaine reward and may reduce alcohol and cocaine craving.”

“ Topiramate , an anticonvulsant, suppresses cravings for alcohol and other substances and is a potential treatment for binge eating.”

“Benzodiazepines, clomethiazole, tiagabine, vigabatrin, pregabalin, gabapentin, acamprosate, naltrexone, GHB, topiramate , ondansetron and baclofen at low dose (≤1 mg/kg, the dose range used in randomized trials in humans: 30 and 60 mg/day) have all been shown to at best reduce motivation to consume alcohol in rats.”

“Results: At the 6-month evaluation, patients taking topiramate had significantly lower scores on the OCDS (all subscales), the EuropASI (medical, alcohol , family/social, and psychiatric) and the WHO/DAS (employment/social).”

“ Topiramate has been shown to increase abstinence from alcohol2 and led to higher levels of spontaneous abstinence from smoking in participants receiving topiramate as treatment for alcohol dependence3.”

“ Topiramate compared with placebo significantly (P < .05 for all comparisons) decreased obsessional thoughts and compulsions about using alcohol , increased subjects' psychosocial well-being, and improved some aspects of quality of life, thereby diminishing the risk of relapse and longer-term negative outcomes.”

“ Topiramate is a sulfamate-substituted fructopyranose derivative that may antagonize the reinforcing effects associated with the abuse liability of alcohol by modulation of cortico-mesolimbic dopamine function.”

“Moreover, topiramate co-administered with ethanol for 3 weeks decreased ethanol-induced memory disturbance in rats.”