What is Topiramate?
Topiramate – also known by trade names including Topamax, Trokendi XR, Qudexy XR and others – is a broad-spectrum anticonvulsant drug provided in tablet form for oral consumption. Chemically described as a sulphonate modified fructose diacetonide, topiramate is a prescription-only medication in the UK.
What is Topiramate Used to Treat?
Topiramate is typically used to treat epilepsy and other conditions causing convulsions. It is also commonly prescribed to prevent migraine (decreasing the frequency of attacks), and for the treatment of Lennox-Gastaut syndrome in children.
Topiramate is also commonly used in the treatment of alcoholism, and is strongly recommended by various authorities in the treatment of alcohol use disorder. Less frequently, it is prescribed in the treatment of obesity and antipsychotic-induced weight gain, and is being investigated as a treatment for post-traumatic stress disorder (PTSD).
Why use Topiramate for Drug Addiction?
Although the precise mechanisms of its action are not yet fully understood, topiramate has been seen to have positive effects in terms of reducing alcohol cravings on the part of alcohol addicts, and extending periods of abstinence. It is also known to decrease the severity of bouts of anxiety and depression which may occur during alcohol withdrawal and detoxification.
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How Do Medications for Addiction Treatment Work?
Various different mechanisms have been proposed for the action of topiramate upon the brain. Most relevantly in terms of the treatment of addiction, topiramate is thought to stimulate the production of GABA – a chemical in the brain which has a calming effect upon the central nervous system (hence its efficacy in reducing seizures) – and to inhibit the production of glutamate, which in turn suppresses the activity of alcohol-induced dopamine, reducing the impact of alcohol upon the brain and body.
Is Topiramate Effective at Treating Alcoholism?
Topiramate should not be seen as a cure for alcoholism by itself; rather, it can reduce cravings and decrease the effect of alcohol upon a drinker, meaning that bouts of drinking are likely to be less frequent and severe, and periods of absence more protracted. It has also been observed to reduce the impact of some of the more distressing alcohol withdrawal symptoms, making relapse less likely in individuals who have gone through detoxification.
Treatment for Drug Addiction
As with any medication used in the treatment of addiction, topiramate should be prescribed as part of a broader addiction treatment programme such as that which may be provided in residential rehabilitation. By itself topiramate is extremely unlikely to halt an addiction, as it deals primarily with consequences rather than root causes.
The Effects of Topiramate on Drinking Behaviours
Alcohol-addicted individuals taking topiramate (in conjunction with psychotherapy) have been seen to reduce the frequency and severity of their drinking, and to have lower rates of relapse than other individuals not taking the drug.
What are the Side Effects of Topiramate?
A large number of side effects have been associated with the consumption of topiramate, including: dizziness; weight loss; nausea; diarrhoea; fatigue; paraesthesia; sleepiness; depression; nasopharyngitis; asthenia; oral paraesthesia; sedation; weight gain; anaemia; gastritis; abdominal discomfort; irritability; blurred vision; lowered attention levels; impaired memory; visual disturbance; abnormal feelings; vertigo; cognitive disorders; hypersensitivity; tinnitus; dysuria; alopecia; impaired motor skills; rashes; convulsions; pruritus; expressive language disorder; anxiety; tremors; muscle spasms; arthralgia; confused state; vomiting; myalgia; aggression; constipation; muscle twitches; muscular weakness; altered mood; agitation; balance disorder; musculoskeletal chest pain; anorexia; pyrexia; mood swings; dry mouth; and abnormal behaviours.
Is Topiramate More Effective When Combined with Addiction Therapy?
As with any medication used in the treatment of addiction, topiramate’s effectiveness is vastly enhanced when it is taken in combination with therapy (and indeed it should only be taken as part of a broader addiction treatment programme with therapy at its heart). Therapy addresses the root causes of addiction, and provides addicts with psychological defence mechanisms against relapse, rather than treating a limited number of symptoms or contributing factors as is the case with topiramate and other medications.
Get Help Today
If you are suffering from an addiction to alcohol or any other substance of abuse, and you are able to acknowledge your condition and ask for help, that help is out there: speak with your GP and/or an addiction specialist today about treatment options you may be able to utilise, and take the first steps on the road back to a happy, healthy life.
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