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Topiramate: Recovery-Focused Treatment for Alcohol Use Disorder

How can topiramate help me cut down or stop drinking?

Topiramate can reduce your urge or desire to drink and can help you reduce or stop drinking. This medicine can also decrease your desire to continue to drink if you start drinking again.

How does topiramate work?

  • Topiramate acts in your brain to reduce your desire to drink alcohol.

  • It can help you drink less and help you choose not to drink.

Will I need other forms of treatment?

A successful alcohol treatment program will include a combination of medicine and social support, like Alcoholics Anonymous (AA) meetings, counseling, individual or group therapy, and sometimes hospital treatment.

What do I need to know before starting topiramate?

  • Topiramate is used for seizures and migraines and it has also been shown to help treat alcohol use disorder.

  • You should not take topiramate if you are pregnant, planning on getting pregnant, or are breastfeeding. Topiramate may make birth control less effective.

  • People with kidney stones should not take topiramate.

  • Topiramate may interact with seizure medicines such as phenytoin, valproic acid, and carbamazepine.

  • Taking medicine for an alcohol use disorder is not substituting one drug for another.

How should I take topiramate?

pills and pill bottle

  • The recommended dose of topiramate for the treatment of alcohol use disorder is 200 milligrams (mg) divided twice daily.

  • To minimize side effects, you will be started on a low dose that will be increased slowly.

  • You should drink plenty of fluids while taking topiramate.

What are some side effects of topiramate? 

Common side effects

What can I do if I experience this?


Rise slowly to prevent falls

Tingling, prickling or numbness of the skin

Avoid irritants such as hot water, tight fitting shoes or clothing

Mental status changes:

  • Slowed thoughts or movements

  • Difficulty concentrating or problems with memory

  • Speech difficulties

Contact your healthcare provider if you feel there are notable worsening signs or symptoms

Weight loss

  • Try to maintain a healthy balanced diet

  • Keep a record of any significant changes in your weight and appetite

Less common side effects, but can be severe:

Tell your healthcare provider immediately if you have any of the following:

  • Mood changes such as depressed mood or irritability.

    • Thoughts of harming yourself or others.

  • Changes in vision.

  • Blood in urine or painful urination.

  • Discuss any symptoms that you think may be due to this medicine with your healthcare provider.

All medicines can have side effects. Not everyone has side effects though. They usually get better as your body gets used to the new medicine.

Talk with your healthcare provider or pharmacist if any of the above side effects trouble you.

How long do I have to take topiramate?

  • You and your healthcare provider will decide on your treatment plan. Most people take topiramate for at least 6 months and often longer.

  • Do not stop your medicine without talking to your healthcare provider first.

Author: StayWell Custom Communications
Last Annual Review Date: 6/1/2018
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