Headache Medication Helps Reduce / Stop Drinking?

A medication, topiramate (brand name Topamax), long used for migraine headaches and as an anti-seizure drug for epileptic patients may revolutionize the treatment of alcoholism and heavy drinking. The substance is a derivative of the naturally-occurring sugar monosaccharide D-fructose.

In earlier short-term research topiramate was found to be effective for helping alcoholics quit or cut back on the amount they drink. Heavy drinkers were six times more likely to remain abstinent for a month if they took the medication, even in small doses.

In the most recent study, those who received topiramate had fewer heavy drinking days, fewer drinks per day and more days of continuous abstinence than those who received the placebo.

Only three medications are currently approved for treating alcoholics in the U.S. by the FDA. They are disulfiram (Antabuse), naltrexone, and acamposate. Antabuse does not reduce cravings but makes people feel sick if they consume alcohol. Both naltrexone and acamposate has been shown to reduce cravings in alcoholics who have already quit drinking.

Topiramate is the only medication shown to be effective for persons who are still drinking. Drinkers get pleasure from alcohol when it releases the chemical dopamine in the brain. Topiramate works by eliminating the excess dopamine so that drinkers no longer get any pleasure from consuming alcohol.

Although approval for treating alcoholism has not been requested from the FDA, there is no prohibition against physicians prescribing the medication "off-label" for that purpose.

The drug can be prescribed by any physician and doesn't require the expertise of a specialist. This should expand the availability of effective treatment to alcoholics and other heavy drinkers.


Note: Neither this website nor its host receives any financial benefit or consideration of any kind from Topamax for reporting this news information.


  • Johnson, Bankole A., et al. Topiramate for Treating Alcohol Dependence - A Randomized Controlled Trial. Journal of the American Medical Association, 2007 (October), 298(14), 1641-1651.
  • Johnson, Bankole A., et al. Oral topiramate for treatment of alcohol dependence: a randomised controlled trial. The Lancet, 2003, 361(9370), 1677-1685.
  • Swift, B. Topiramate for the treatment of alcohol dependence: initiating abstinence. The Lancet, 2003, 361(9370), 1666-1667.

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