New indications for topiramate: alcohol dependency and binge-eating disorder

Background: Topiramate was originally developed as an anti-epileptic but has recently been tested in motivated subjects with alcohol dependency and with binge-eating disorder (BED). Method: Evaluation of recent clinical trials. Results: In the trial with subjects with alcohol dependency, the primary efficacy outcome was the percentage of heavy drinking days, which fell to a greater extent with topiramate (from 82 to 40%). In the trial with subjects with BED, the primary efficacy measure was weight change. Weight decreased from 98.4 to 97.5 kg in the placebo group, and from 96.6 to 89.8 kg in the topiramate group over 21 weeks. Conclusion: Topiramate may be indicated in alcohol dependency and BED. However, it is not known whether benefits with topiramate are retained in the long term, nor whether topiramate will be effective in subjects with less resolve.