An 18-week experimental study, published in Clinical and experimental alcohol research, When examining the effects of the drug topiramate on tobacco smoking and alcohol consumption, no differences were found between the groups treated with topiramate and those given a placebo treatment in the last four weeks of treatment.
However, the authors reported a lower average percentage of heavy drinking days and drinks per day in participants treated with the highest dose of the substance tested compared to the other groups in the assessments conducted after the target quit date.
Topiramate is a prescription drug originally developed as an anticonvulsant to treat seizures. It is also commonly used for migraine prevention and, in combination with other medicines, for weight management.
The drug works by modulating multiple neurotransmitter systems, including enhancing the activity of the inhibitory neurotransmitter GABA and decreasing the excitatory activity of the neurotransmitter glutamate. Because of these mechanisms, topiramate may reduce the increased excitability of neurons in the brain.
The drug is sometimes used off-label for conditions such as bipolar disorder, alcohol use disorder, and binge eating disorder.
Study author Jason D. Robinson and his colleagues wanted to investigate whether topiramate would be effective in treating individuals with alcohol and tobacco use disorders.
More specifically, they wanted to see whether 250 mg and 125 mg of topiramate per day would result in reducing heavy drinking and cigarette smoking behavior in individuals motivated to try to quit both substances.
The study authors hypothesized that the higher dose would be more effective than the lower dose.
“Although primary analyzes showed no evidence that topiramate reduces drinking and smoking behavior, likely driven by high dropout rates and poor adherence, exploratory repeated measures analyzes suggest that topiramate 250 mg reduces drinking behavior and that both the 125 mg and 250 mg doses reduce smoking behavior,” the study authors concluded.
