beth israel deaconess medical center a harvard medical school teaching hospital

To find a doctor, call 800-667-5356 or click below:

Find a Doctor

Request an Appointment

left banner
right banner
Smaller Larger

Medication May Reduce Heavy Drinking and Increase Abstinence in Alcoholics

En Español (Spanish Version)

Do you or a loved one suffer from alcohol dependence or abuse ? If so, you know how difficult treatment can be. There may be some hope for those who struggle from alcohol dependence. There may be a medication that helps reduce the amount of alcohol consumed and increase the length of abstinence.

In a study published in the October 2007 Journal of the American Medical Association , researchers compared the amount of alcohol consumed in patients who took the medication topiramate (Topamax) and those that took a placebo (an inactive substance resembling a medication). All patients had weekly Brief Behavioral Compliance Enhancement Treatment (BBCET) intervention to emphasize medication adherence. Researchers found that patients taking the medication consumed less alcohol and had more days abstinent.

About the Study

Researchers enrolled 371 patients aged 18-65 years with alcohol dependence into the study. Half of the patients took topiramate (Topamax) starting at 25 mg once daily and increased to 300 mg/day in two divided doses for 14 weeks. The other half took a placebo. Heavy drinking days were defined as ≥5 standard drinks for men and ≥4 for women per day. All patients drank ≥28 (for women) or ≥35 (for men) standard drinks per week at baseline (the start of the study). Drinking reduction was assessed weekly by a self-reported patient diary and a blood test measured at weeks zero, four, eight, 12, and 14.

After 14 weeks, more patients who took topiramate experienced a decreased amount of alcohol consumed daily and a decreased number of heavy drinking days. The most hopeful piece of the study is that 15% of patients achieved ≥28 days of continuous abstinence with topiramate vs. 3.2% with placebo, and 30% achieved ≥28 days of continuous nonheavy drinking.

How Does This Affect You?

This study suggests that topiramate, a medication commonly used in seizure disorders, may help reduce the amount of alcohol consumed by alcohol-dependent people and contribute to prolonging abstinence. There were many side effects in the group who took topiramate, including paresthesias (a sensation of pricking, tingling, or creeping on the skin), taste perversion, loss of appetite, difficulty with concentration or attention, nervousness, dizziness, and pruritis . There are also other treatments available including other medications (acamprosate or disulfiram) and psychosocial support programs. Talk to your doctor about which treatment is best for you.

The poor health and social effects of excessive alcohol use are many. Breaking alcohol dependency is difficult and requires support from friends and family. Continuing abstinence is one of the most difficult steps. If topiramate can reduce the amount of alcohol consumed, it should also improve general health. It is not clear why this medication helps, but it does offer hope for a devastating disease.




  • Johnson BA, Rosenthal N, Capece JA, Wiegand F, Mao L, Beyers K, et al. Topiramate for treating alcohol dependence: a randomized controlled trial. JAMA . 2007 Oct 10;298(14):1691-2.

Last reviewed November 2007 by Larissa Lucas, MD

All EBSCO Publishing proprietary, consumer health and medical information found on this site is accredited by URAC. URAC's Health Web Site Accreditation Program requires compliance with 53 rigorous standards of quality and accountability, verified by independent audits. To send comments or feedback to our Editorial Team regarding the content please email us at

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

Search Your Health