Objectives: Pathological gambling (PG) is a prevalent disorder with no approved
pharmacological treatment. Previous reports suggest that topiramate could be useful in
reducing impulsivity in PG, and craving in other addictions. The goal of this study was to
investigate the effectiveness of topiramate combined with brief cognitive restructuring in
treating PG. Methods: 38 PG patients were randomized to either topiramate (N=18) or placebo
(N=20) in a 12-week double-blind trial; all patients received brief cognitive restructuring.
The main outcome measures were craving, gambling behaviour, gambling cognitive distortions,
impulsivity, depression and social adjustment.