A randomized, placebo-controlled proof-of-concept trial of adjunctive topiramate for alcohol use disorders in bipolar disorder.
BACKGROUND AND OBJECTIVES
Topiramate is effective for alcohol use disorders (AUDs) among non-psychiatric patients. We examined topiramate for treating comorbid AUDs in bipolar disorder (BD).


METHODS
Twelve participants were randomized to topiramate or placebo for 12 weeks.


RESULTS
The topiramate group, with two out of five participants (40%) completing treatment, experienced less improvement in drinking patterns than the placebo group, with five out of seven participants (71%) completing treatment.


DISCUSSION AND CONCLUSIONS
Topiramate did not improve drinking behavior and was not well-tolerated. This study failed to recruit adequately. Problems surrounding high attrition, a small study sample, and missing data preclude interpretation of study findings.


SCIENTIFIC SIGNIFICANCE
This is the first randomized, placebo-controlled trial of topiramate for AUDs in BD.