Topiramate for Cocaine Dependence: A Systematic Review and Meta-Analysis of Randomized Control Trials.
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CitationTopiramate for Cocaine Dependence: A Systematic Review and Meta-Analysis of Randomized Control Trials. 2016: Addiction
JournalAddiction (Abingdon, England)
AbstractTo 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.
We searched six scientific databases from inception to December 23, 2014 with no date limits. Data were systematically reviewed, extracted and analyzed. 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-analytic model was computed.
Five studies met inclusion criteria (n = 518). Topiramate was compared with placebo (4 studies), and no medication (1 study). In a meta-analysis, we observed no significant differences between topiramate and placebo in improving treatment retention (risk ratio [RR] = 0.84; 95% Confidence Interval [CI]: 0.67-1.05, p = 0.12). However, compared with a placebo, use of topiramate was associated with increased continuous abstinence in two of five studies (RR = 2.52; 95% CI: 1.35-4.73, p = 0.004). No differences were observed in frequency of adverse effects reported between topiramate and placebo (RR=1.03; 95% CI = 0.87-1.23, p=0.72). Topiramate was significantly associated (p<0.05) with a reduction in craving in only one of five studies.
Evidence does not currently support the use of topiramate to improve treatment retention for cocaine use disorder, though it may extend cocaine abstinence with a similar risk of adverse events compared with placebo.
Item TypeArticle In Press
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