I have seen several editorials recently pushing topiramate, a relatively new generation anti-epileptic medication, for patients who are heavy alcohol users. A couple of recent studies provide the research base for this renewed interest (for example, Kranzler et al 2014 available here) and comparisons with naltrexone and disulfiram have shown some promise but hardly suggest topiramate is a panacea. Alcohol dependency is notoriously difficult to treat successfully, but many people recover, often without professional help. The costs of alcohol harmful use for society have been estimated in a number of studies and they are huge so governments are also interested in what is a significant public health issue. New pharmacological approaches are of course welcome, but I suspect the emphasis in treatment will remain psychological for some time to come.