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Topiramate for cocaine dependence: a systematic review and meta-analysis of randomized controlled trials.
- Source :
- Addiction; Aug2016, Vol. 111 Issue 8, p1337-1346, 10p, 1 Diagram, 2 Charts
- Publication Year :
- 2016
-
Abstract
- 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 < 0.05) with a reduction in craving in only one of five studies. Conclusions Evidence does not currently support the use of topiramate to improve treatment retention for cocaine use disorder, although it may extend cocaine abstinence with a similar risk of adverse events compared with placebo. [ABSTRACT FROM AUTHOR]
- Subjects :
- TOPIRAMATE
COCAINE abuse treatment
DRUG efficacy
TREATMENT of drug addiction
META-analysis
PSYCHOSOCIAL factors
PLACEBOS
THERAPEUTICS
CINAHL database
COCAINE
DESIRE
DRUG addiction
INFORMATION storage & retrieval systems
MEDICAL databases
MEDICAL information storage & retrieval systems
PSYCHOLOGY information storage & retrieval systems
MEDLINE
CLASSIFICATION of mental disorders
ONLINE information services
RESEARCH funding
SYSTEMATIC reviews
RANDOMIZED controlled trials
RELATIVE medical risk
TREATMENT effectiveness
DESCRIPTIVE statistics
Subjects
Details
- Language :
- English
- ISSN :
- 09652140
- Volume :
- 111
- Issue :
- 8
- Database :
- Complementary Index
- Journal :
- Addiction
- Publication Type :
- Academic Journal
- Accession number :
- 116708696
- Full Text :
- https://doi.org/10.1111/add.13328