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The anticonvulsant topiramate stimulates γ-aminobutyric acid receptors and inhibits glutamate receptors; because these neurotransmitter effects are important in dampening alcohol dependence, researchers previously conducted a brief, controlled trial that showed benefit with topiramate’s use in alcohol dependence. Now, in a larger, longer, industry-funded study, 371 people with alcohol dependence (mean age, 47; 74% men) were randomized to daily topiramate (≤300 mg; mean dose, 171 mg) or placebo. All participants received weekly psychosocial support and education; abstinence was not required to begin treatment or during the trial.
At 14 weeks of follow-up, compared with controls, intervention subjects showed a greater decrease in percentage of…