Hi Minimouse:
Not sure where you live, or why you're sure you're doc won't prescribe 'off label'. I'm in the US and when I originally told my doc of my goal to cut alcohol intake he said "there are drugs to help that" so that when I went back to ask for Topo there was no problem. He also prescribes Topo for weight loss! so I guess this is not considered "off label" in our locality.
RE: will Topo help w/ "compulsion" vs. craving? I'm not sure I can differentiate the two for you. . . Initially I would have said I did not have cravings, but rather felt that "I" would decide not to drink, and it would seem "another" decided to pour: is that craving or compulsion? . . I don't know.
All I can tell you is that with MWO, effort, work and support I have been successfully modderating for almost 5 months and I DO NOT drink all that is there and am almost always "completely satisfied" with one or two drinks. Mind you for the first 4 months I did not have alcohol in the house, and only drank when out with others, where access to alcohol was limited. I still have to be very mindful with alcohol at home alone.
RE: whether to take meds with or without doc knowing, that depends on your age, health problems and other meds you might be taking. I'd say if you are young, have no other health problems and take no other meds, there is probably enough info on this website re: side effects and dosage adjustments to get you through. Although not a replacement for medical advice, this site does provide a level of insight and help that you won't find many places.
If you do take Topo I'll just add my 2 cents re: side effects: it took me 4 months to find a dose and schedule in which I didn't have side effects (tingling, some word loss). I wish I'd read advice earlier to consider evening dosing. Also, start low and go slow. I had symptoms on 100 mg and when I switched to 75 (split 25 am/50 pm) all symptoms ceased - YA hooo!) I figured you needed at least 100 to work, but NOT TRUE!
Hope that is helpful? Best to you!
AFH
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