Topiramate for cocaine dependence: a systematic review and meta-analysis of randomized controlled trials

Aims To assess the efficacy of topiramate in treating cocaine use disorder (i.e. retention, efficacy, safety and craving reduction) through a systematic review and meta‐analysis. Methods We searched six scientific databases from inception to 23 December 2014 with no date limits. Data were reviewed,...

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Bibliographic Details
Published in:Addiction (Abingdon, England) England), 2016-08, Vol.111 (8), p.1337-1346
Main Authors: Singh, Mohit, Keer, Dipinder, Klimas, Jan, Wood, Evan, Werb, Dan
Format: Article
Language:English
Subjects:
Anticonvulsants - therapeutic use
Clinical trials
Cocaine
Cocaine abuse
cocaine addiction
cocaine dependence
cocaine use disorder
Cocaine-Related Disorders - drug therapy
Craving
Drug addiction
Fructose - analogs & derivatives
Fructose - therapeutic use
Humans
Meta-analysis
Narcotics
Randomized Controlled Trials as Topic
review
Substance abuse treatment
Systematic review
topiramate
Treatment Outcome
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Summary:Aims To assess the efficacy of topiramate in treating cocaine use disorder (i.e. retention, efficacy, safety and craving reduction) through a systematic review and meta‐analysis. Methods We searched six scientific databases from inception to 23 December 2014 with no date limits. Data were reviewed, extracted and analysed systematically. Studies were included if they were peer‐reviewed randomized control trials with participants meeting diagnostic criteria for cocaine dependence or cocaine use disorder, with the treatment arm involving topiramate with or without psychosocial intervention, and the control arm involving no intervention or psychosocial intervention with or without placebo. A random‐effects meta‐analytical model was computed. Results Five studies met inclusion criteria (n = 518). Topiramate was compared with placebo (four studies) and no medication (one study). In a meta‐analysis, we observed no significant differences between topiramate and placebo in improving treatment retention risk ratio (RR) = 0.85; 95% confidence interval (CI) = 0.60–1.22, P = 0.38. However, compared with a placebo, use of topiramate was associated with increased continuous abstinence in two of five studies (RR = 2.43; 95% CI = 1.31–4.53, P = 0.005). No differences were observed in frequency of adverse effects reported between topiramate and placebo (RR = 1.06; 95% CI = 0.91–1.23, P = 0.48). Topiramate was associated significantly (P 
ISSN:0965-2140
1360-0443
DOI:10.1111/add.13328