Topamax is an antiseizure medication that’s also given for bipolar disorder. Topamax (topiramate) has also been the subject of a lot of study for its use in the treatment of cocaine and alcohol abuse. The studies have been thorough and indicate a moderate effectiveness. It’s not a magic solution for sure, but it does hold promise for treating addiction to alcohol and cocaine. The studies have been conducted at the University of Pennsylvania School of Medicine.
Topamax for Alcohol and Cocaine Abuse
Topiramate seems to reduce cravings for alcohol. It does not reduce cravings for cocaine. However, cocaine addicts taking topiramate stayed in treatment more often than those on a placebo and endured less severe withdrawal symptoms, particularly depression, restlessness, and agitation.
Topiramate works on the neurotransmitter GABA (gamma amino butyric acid), which is one of the most important neurotransmitters affected by drugs of addiction, along with dopamine, serotonin, and norepinephrine. GABA tends to reduce, or modulate the amount of dopamine in the brain. Dopamine controls the pleasure response of the brain, thus by preventing dopamine from spiking after using cocaine or alcohol, the desired pleasure is not there.
However, taking away the pleasure from the drug use does not take away topiramate’s effectiveness in controlling withdrawal symptoms. Thus if a patient relapses, the relapse is likely to stop as soon as it starts. Topiramate seems most effective for treatment of long term chronic alcoholics and heavy users of cocaine. It’s less effective in those whose drug consumption is lower.
The “success” level for people on topiramate versus a placebo was about 10 percent. While that may not seem like a lot, adding topiramate to drug treatment may have an overall cumulative effect that benefits a person in recovery greatly. Everything that helps should be welcome, as long as topiramate’s side effects, which are minimal, do no harm. Although many people oppose “getting off drugs by taking drugs,” no one would deny an addict with diabetes their insulin. If we really are looking at addiction as a disease, a disorder of biology and neurology, we have to consider medication, and medication assisted therapy as a helper to treatment. No one is thinking of using topiramate as a substitute for treatment program. However, using it as part of an overall balanced treatment approach could benefit alcoholics and cocaine addicts who are trying to get into recovery and stay there.