Psychopharmacology and Psychiatry Updates Naltrexone vs. Topiramate: FDA-Approved vs. Off-Label Options for MAUD
Jun 30, 2025
This discussion delves into the rising concern of alcohol use disorder in the U.S. Both naltrexone and topiramate are examined for their roles in treatment, revealing intriguing findings that suggest they might be equally effective. Genetic factors are considered for personalized recovery strategies. With topiramate emerging as a promising option, listeners explore whether it could serve as an effective alternative to the FDA-approved medication. The implications for patient care and individualized treatment decisions are emphasized throughout.
AI Snips
Chapters
Transcript
Episode notes
Topiramate Matches Naltrexone Efficacy
- Topiramate, an off-label medication, shows comparable effectiveness to FDA-approved naltrexone for alcohol use disorder.
- Both drugs reduced heavy drinking by over 60%, challenging existing treatment norms.
Topiramate’s Widespread Off-Label Use
- Topiramate is used more frequently off-label for AUD than all three FDA-approved medications combined.
- Clinical guidelines rank it as a second-line treatment despite lack of FDA approval for AUD.
Topiramate Reduces Craving More
- Topiramate reduced alcohol craving about 25% more than naltrexone.
- Both medications produced rapid and sustained reductions in drinking behaviors.