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Topiramate
 
Topiramate was originally used to treat epilepsy, and is now also FDA approved as a treatment for migraines. It is used “off label” to help alcoholics stop drinking. Topiramate can reduce craving and is particularly helpful early in early abstinence to help alcoholics avoid returning to regular drinking.  Side effects may include drowsiness, dizziness, loss of coordination, loss of appetite, cognitive impairment, weight loss, tingling of the hands/feet, diarrhea, eye problems and nausea.  Topiramate may decrease the effectiveness of estrogen-containing oral contraceptives, and taking topiramate in the 1st trimester of pregnancy may increase risk of cleft lip/cleft palate in the infant. Therefore, women of childbearing age who use this drug must use alternative, non-hormone based forms of contraception. Topiramate can cause a reduction in sweating, putting people at greater risk of heat related problems like heatstroke.
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