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Background:  Topiramate was recently reported to be efficacious in reducing drinking rates and craving among individuals with alcohol dependence in a randomized controlled trial, but dose effects could not be determined. This laboratory study systematically examined the dose‐dependent effects of topiramate on cue‐elicited craving and other putative mechanisms of its pharmacotherapeutic effects on drinking.

Methods:  Male and female heavy drinkers (n = 61) were randomized to 1 of 3 medication conditions (200 mg/d; 300 mg/d; placebo) in a double‐blind study. Participants reached the target dose after a 32‐day titration period, then were stabilized for approximately 1 week. All then participated in a laboratory assessment of alcohol cue reactivity and of the subjective effects of a moderate dose of alcohol.

Results:  Both doses of topiramate reduced the frequency of heavy drinking during the titration …