Topamax Dosage

Hello Dr. Garcia,

I have a question about Topamax dosage(s).

My internist prescibed it for me for help with alcohol cessation on Tuesday (3/7) ironically before I discovered this website and the book which I downloaded in pdf form. He gave me a month sample which ultimately ramps me up to 100 mg by week four (divided into two 50 mg dosages). My prescription is for 100 mg a day after the samples are gone. In your clinical experience, will this be enough or should I discuss increasing it with him?

I am 40, male, a binge drinker (as I read the book, it was incredibly eerie to read because I kept thinking to myself, "that's me"), I would like to remain abstinent until after Easter (I've not had anything to drink in 10 days and gave up wine for Lent) and then learn to become a moderate, social drinker (I love wine, in fact I am a wine collecter with a 3000 bottle cellar--heck of a hobby to have!!).

I've realistically have had a drinking problem for 10 years--at least the length of time that I've been concerned about my drinking patterns/behavior--but has really seemed to escalate over the last few years. My drinking habits probably developed while in college and grad school because we always drank to get drunk and tried to drink as much as possible. I never learned to drink in moderation. For me, it has always been all or nothing and, unfortunately, that is part of my personality which also tends to be a tad bit impulsive/compulsive (toss in a little adhd to boot).

Thanks for your time.

Fred

Hi, Fred and thanks for the question. Topiramate dosing can be highly variable, although we do follow the titration chart used by Dr. Bankole Johnson et al in getting our patients to the proper level. This may be 150 to 300 mg. depending on an individual's weight, how they metabolize medication, and other factors. The amount you described (100 mg. per day) may or may not be adequate, but you should be able to tell based on how you are coping with cravings. Discuss with your doctor how you’re feeling as you continue to take your medicine and adhere to the other aspects of the MWO program. Good work with the program.

--Dr. Garcia