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Topiramate in the treatment of alcohol dependence: a meta-analysis
B Arbaizar1, T Diersen-Sotos, I Gómez-Acebo
1Mental Health Unit Hospital Laredo Cantabria, Spain.
Unlabelled:
Several controlled clinical trials have studied the efficacy of topiramate in the treatment of alcoholism. In this paper, we have performed a meta-analysis of those trials in which topiramate was compared with placebo and then we reviewed its efficacy in trials in which it was compared with other drugs.
Method:
A quantitative synthesis of data was per-formed using inverse variance weighting in a random effects model.
Results:
Based on three placebo-controlled trials, topiramate is more efficacious than placebo in reducing the percentage of heavy drinking days (23.2%, 95% confidence interval [CI]: 15.7 to 34.4), increasing the number of days of abstinence (mean difference: 2.9 days, 95% CI: 2.5 to 3.3),and lowering the logarithm of g-GT levels (mean difference:0.075 95% CI: 0.048 to 0.118). Two trials suggested that topiramate is also more efficacious than naltrexone, and one open-label study reported better results for disulfiram than for topiramate.
Conclusion:
Topiramate can be used in alcohol dependence. Adverse effects such as paresthesia or insomnia should be taken into account when prescribing topiramate.Its optimal dosage requires further research.
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