LL
Sounds like you are ready for change! Acknowledging you have a problem is a huge step.
I am not sure why some doctors won't prescribe antabuse. Mine was a little apprehensive, but did, and referred me to a shrink. I am seeing a counselor now, and I honestly think that this has helped me more than anything else. I am no longer on antabuse. I was only on it for a wee while. It is an excellent tool! Lots of people here are using it.
I don't know anything about Topamax. There is a lot of discussion about it in the medication part of this forum.
My suggestion is to take one day at a time. Just get through each day without thinking too far ahead. If your job is on the line; then now is probably a good time to do what you need to do. Don't worry about the next work social gathering. Only focus on today.
Keep reading, and posting. Glad you found us.