Alcohol use disorder (AUD) and posttraumatic stress disorder (PTSD) frequently co-occur, and
having both disorders is associated with greater psychological and functional impairment than
having either disorder alone. The most effective PTSD treatment, prolonged exposure (PE) is
sometimes less effective when individuals also have AUD. Anti-relapse medication appears
promising to improve the effectiveness of PE to help individuals reduce alcohol use and PTSD
symptoms and improve functioning. This study compares PE with and without topiramate, a
medication shown to both reduce drinking and PTSD symptoms, with the hypothesis that combined
PE and topiramate will be more effective than PE and placebo. The aim of this grant is to
improve treatment outcomes for Veterans with AUD and PTSD.