A Meta-Analysis of Topiramate's Effects for Individuals with Alcohol Use Disorders
Background Influenced by several trials and reviews highlighting positive outcomes, topiramate is increasingly prescribed as a treatment for alcohol use disorders (AUDs). The only previously published meta‐analysis of topiramate for AUDs was limited by a sample of only 3 randomized, placebo‐controll...
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| Veröffentlicht in: | Alcoholism, clinical and experimental research clinical and experimental research, 2014-06, Vol.38 (6), p.1481-1488 |
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| container_title | Alcoholism, clinical and experimental research |
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| creator | Blodgett, Janet C. Del Re, A. C. Maisel, Natalya C. Finney, John W. |
| description | Background
Influenced by several trials and reviews highlighting positive outcomes, topiramate is increasingly prescribed as a treatment for alcohol use disorders (AUDs). The only previously published meta‐analysis of topiramate for AUDs was limited by a sample of only 3 randomized, placebo‐controlled trials (RCTs).
Methods
A systematic search identified 7 RCTs (including a total of 1,125 participants) that compared topiramate to placebo for the treatment for AUDs. This meta‐analysis estimated the overall effects of topiramate on abstinence, heavy drinking, craving, and γ‐glutamyltranspeptidase (GGT) outcomes and included several sensitivity analyses to account for the small sample of studies.
Results
Overall, the small to moderate effects favored topiramate, although the effect on craving was not quite significantly different from 0. The largest effect was found on abstinence (g = 0.468, p |
| doi_str_mv | 10.1111/acer.12411 |
| format | Article |
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Influenced by several trials and reviews highlighting positive outcomes, topiramate is increasingly prescribed as a treatment for alcohol use disorders (AUDs). The only previously published meta‐analysis of topiramate for AUDs was limited by a sample of only 3 randomized, placebo‐controlled trials (RCTs).
Methods
A systematic search identified 7 RCTs (including a total of 1,125 participants) that compared topiramate to placebo for the treatment for AUDs. This meta‐analysis estimated the overall effects of topiramate on abstinence, heavy drinking, craving, and γ‐glutamyltranspeptidase (GGT) outcomes and included several sensitivity analyses to account for the small sample of studies.
Results
Overall, the small to moderate effects favored topiramate, although the effect on craving was not quite significantly different from 0. The largest effect was found on abstinence (g = 0.468, p < 0.01), followed by heavy drinking (g = 0.406, p < 0.01), GGT (g = 0.324, p = 0.02), and craving (g = 0.312, p = 0.07) outcomes. Sensitivity analyses did not change the magnitude or direction of the results, and tests did not indicate significant publication bias. The small sample size did not allow for examination of specific moderators of the effects of topiramate.
Conclusions
Topiramate can be a useful tool in the treatment of AUDs. Its efficacy, based on the current sample of studies, seems to be of somewhat greater magnitude than that of the most commonly prescribed medications for AUDs (naltrexone and acamprosate). Further research will help to identify the contexts in which topiramate is most beneficial (e.g., dose, concurrent psychotherapy, patient characteristics).</description><identifier>ISSN: 0145-6008</identifier><identifier>EISSN: 1530-0277</identifier><identifier>DOI: 10.1111/acer.12411</identifier><identifier>PMID: 24796492</identifier><identifier>CODEN: ACRSDM</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Alcohol Drinking - drug therapy ; Alcohol Drinking - epidemiology ; Alcohol Use Disorders ; Alcoholism - drug therapy ; Excitatory Amino Acid Antagonists - therapeutic use ; Fructose - analogs & derivatives ; Fructose - therapeutic use ; Humans ; Meta-Analysis ; Topiramate ; Treatment ; Treatment Outcome</subject><ispartof>Alcoholism, clinical and experimental research, 2014-06, Vol.38 (6), p.1481-1488</ispartof><rights>Published 2014. This article is a U.S. Government work and is in the public domain in the USA.</rights><rights>2014 Research Society on Alcoholism</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4861-3d66768633685d1d6c2f5d1c1c6463ae5def9441892a28f99a2192c45e4cf2303</citedby><cites>FETCH-LOGICAL-c4861-3d66768633685d1d6c2f5d1c1c6463ae5def9441892a28f99a2192c45e4cf2303</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Facer.12411$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Facer.12411$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,780,784,885,1416,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24796492$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Blodgett, Janet C.</creatorcontrib><creatorcontrib>Del Re, A. C.</creatorcontrib><creatorcontrib>Maisel, Natalya C.</creatorcontrib><creatorcontrib>Finney, John W.</creatorcontrib><title>A Meta-Analysis of Topiramate's Effects for Individuals with Alcohol Use Disorders</title><title>Alcoholism, clinical and experimental research</title><addtitle>Alcohol Clin Exp Res</addtitle><description>Background
Influenced by several trials and reviews highlighting positive outcomes, topiramate is increasingly prescribed as a treatment for alcohol use disorders (AUDs). The only previously published meta‐analysis of topiramate for AUDs was limited by a sample of only 3 randomized, placebo‐controlled trials (RCTs).
Methods
A systematic search identified 7 RCTs (including a total of 1,125 participants) that compared topiramate to placebo for the treatment for AUDs. This meta‐analysis estimated the overall effects of topiramate on abstinence, heavy drinking, craving, and γ‐glutamyltranspeptidase (GGT) outcomes and included several sensitivity analyses to account for the small sample of studies.
Results
Overall, the small to moderate effects favored topiramate, although the effect on craving was not quite significantly different from 0. The largest effect was found on abstinence (g = 0.468, p < 0.01), followed by heavy drinking (g = 0.406, p < 0.01), GGT (g = 0.324, p = 0.02), and craving (g = 0.312, p = 0.07) outcomes. Sensitivity analyses did not change the magnitude or direction of the results, and tests did not indicate significant publication bias. The small sample size did not allow for examination of specific moderators of the effects of topiramate.
Conclusions
Topiramate can be a useful tool in the treatment of AUDs. Its efficacy, based on the current sample of studies, seems to be of somewhat greater magnitude than that of the most commonly prescribed medications for AUDs (naltrexone and acamprosate). Further research will help to identify the contexts in which topiramate is most beneficial (e.g., dose, concurrent psychotherapy, patient characteristics).</description><subject>Alcohol Drinking - drug therapy</subject><subject>Alcohol Drinking - epidemiology</subject><subject>Alcohol Use Disorders</subject><subject>Alcoholism - drug therapy</subject><subject>Excitatory Amino Acid Antagonists - therapeutic use</subject><subject>Fructose - analogs & derivatives</subject><subject>Fructose - therapeutic use</subject><subject>Humans</subject><subject>Meta-Analysis</subject><subject>Topiramate</subject><subject>Treatment</subject><subject>Treatment Outcome</subject><issn>0145-6008</issn><issn>1530-0277</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1PGzEQhi1UVAL00h9QWeqhEtJSj-21dy9IqzQExJeEgjhartduDJs42Bsg_75OA1F76VzmMM-8M3oQ-gzkGHJ918bGY6AcYAcNoGSkIFTKD2hAgJeFIKTaQ_spPRBCeCXER7RHuawFr-kA3Tb4yva6aOa6WyWfcHB4EhY-6pnu7beER85Z0yfsQsTn89Y_-3apu4RffD_FTWfCNHT4Lln8w6cQWxvTIdp1mbCf3voBujsdTYZnxeXN-HzYXBYmfwEFa4WQohKMiapsoRWGutwNGMEF07Zsras5h6qmmlaurjWFmhpeWm4cZYQdoJNN7mL5c2ZbY-d91J1aRD_TcaWC9urfydxP1a_wrDjhEqp1wNe3gBieljb16iEsYxaRFEghZXYky0wdbSgTQ0rRuu0FIGrtX639qz_-M_zl75-26LvwDMAGePGdXf0nSjXD0e17aLHZ8am3r9sdHR-VkEyW6v56rOjFRJyNh1wB-w1yDZ6A</recordid><startdate>201406</startdate><enddate>201406</enddate><creator>Blodgett, Janet C.</creator><creator>Del Re, A. C.</creator><creator>Maisel, Natalya C.</creator><creator>Finney, John W.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>K7.</scope><scope>K9.</scope><scope>5PM</scope></search><sort><creationdate>201406</creationdate><title>A Meta-Analysis of Topiramate's Effects for Individuals with Alcohol Use Disorders</title><author>Blodgett, Janet C. ; Del Re, A. C. ; Maisel, Natalya C. ; Finney, John W.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4861-3d66768633685d1d6c2f5d1c1c6463ae5def9441892a28f99a2192c45e4cf2303</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Alcohol Drinking - drug therapy</topic><topic>Alcohol Drinking - epidemiology</topic><topic>Alcohol Use Disorders</topic><topic>Alcoholism - drug therapy</topic><topic>Excitatory Amino Acid Antagonists - therapeutic use</topic><topic>Fructose - analogs & derivatives</topic><topic>Fructose - therapeutic use</topic><topic>Humans</topic><topic>Meta-Analysis</topic><topic>Topiramate</topic><topic>Treatment</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Blodgett, Janet C.</creatorcontrib><creatorcontrib>Del Re, A. C.</creatorcontrib><creatorcontrib>Maisel, Natalya C.</creatorcontrib><creatorcontrib>Finney, John W.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Criminal Justice (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Alcoholism, clinical and experimental research</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Blodgett, Janet C.</au><au>Del Re, A. C.</au><au>Maisel, Natalya C.</au><au>Finney, John W.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A Meta-Analysis of Topiramate's Effects for Individuals with Alcohol Use Disorders</atitle><jtitle>Alcoholism, clinical and experimental research</jtitle><addtitle>Alcohol Clin Exp Res</addtitle><date>2014-06</date><risdate>2014</risdate><volume>38</volume><issue>6</issue><spage>1481</spage><epage>1488</epage><pages>1481-1488</pages><issn>0145-6008</issn><eissn>1530-0277</eissn><coden>ACRSDM</coden><abstract>Background
Influenced by several trials and reviews highlighting positive outcomes, topiramate is increasingly prescribed as a treatment for alcohol use disorders (AUDs). The only previously published meta‐analysis of topiramate for AUDs was limited by a sample of only 3 randomized, placebo‐controlled trials (RCTs).
Methods
A systematic search identified 7 RCTs (including a total of 1,125 participants) that compared topiramate to placebo for the treatment for AUDs. This meta‐analysis estimated the overall effects of topiramate on abstinence, heavy drinking, craving, and γ‐glutamyltranspeptidase (GGT) outcomes and included several sensitivity analyses to account for the small sample of studies.
Results
Overall, the small to moderate effects favored topiramate, although the effect on craving was not quite significantly different from 0. The largest effect was found on abstinence (g = 0.468, p < 0.01), followed by heavy drinking (g = 0.406, p < 0.01), GGT (g = 0.324, p = 0.02), and craving (g = 0.312, p = 0.07) outcomes. Sensitivity analyses did not change the magnitude or direction of the results, and tests did not indicate significant publication bias. The small sample size did not allow for examination of specific moderators of the effects of topiramate.
Conclusions
Topiramate can be a useful tool in the treatment of AUDs. Its efficacy, based on the current sample of studies, seems to be of somewhat greater magnitude than that of the most commonly prescribed medications for AUDs (naltrexone and acamprosate). Further research will help to identify the contexts in which topiramate is most beneficial (e.g., dose, concurrent psychotherapy, patient characteristics).</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>24796492</pmid><doi>10.1111/acer.12411</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Alcoholism, clinical and experimental research, 2014-06, Vol.38 (6), p.1481-1488 |
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| source | MEDLINE; Journals@Ovid Complete; Wiley Online Library All Journals |
| subjects | Alcohol Drinking - drug therapy Alcohol Drinking - epidemiology Alcohol Use Disorders Alcoholism - drug therapy Excitatory Amino Acid Antagonists - therapeutic use Fructose - analogs & derivatives Fructose - therapeutic use Humans Meta-Analysis Topiramate Treatment Treatment Outcome |
| title | A Meta-Analysis of Topiramate's Effects for Individuals with Alcohol Use Disorders |
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