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Few medications have been shown to reduce drinking behavior in patients with alcohol dependence, and thus medications have played a limited role in alcoholism treatment. Preclinical data have suggested that the novel anticonvulsant topiramate might blunt the alcohol-induced increases in mesolimbic dopamine that reinforce alcohol dependence; thus, topiramate might decrease the chronic changes in glutamate receptor sensitivity that possibly facilitate these dopamine increases. In a partially manufacturer-supported study on the efficacy of topiramate for alcoholism, researchers randomized 150 alcohol-dependent patients (average daily intake, approximately 9 drinks) to receive topiramate (doses escalated to 300 mg daily) or placebo. All patient…