A Bayesian meta-analysis of topiramate’s effectiveness for individuals with alcohol use disorder
Year: 2023
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Background: Topiramate (TPM) has the potential to become one of the most prominent treatment options for alcohol use disorder (AUD). We investigated the efficacy of TPM for AUD treatment, considering new randomized controlled trials carried out since the publication of four prior investigations. Methods: We searched six major databases, comparing TPM to placebo for AUD treatment. We performed a Bayesian meta-analysis. We conducted a meta-regression, analyzing the effect of age, TPM dosage, duration of treatment, gender, and attrition rate on the outcomes measured. The protocol is registered with PROSPERO: CRD42021286266. Results: TPM reduced heavy drinking days ( d = 0.401, Bayes factor (BF) = 23.088) and weeks ( d = 0.461, BF = 3.784), lowered alcohol craving ( d = 0.477, BF = 107.749), prolonged abstinence throughout the duration of trials ( d = 0.505, BF = 54.998), and decreased the amount of gamma-glutamyl transferase in the blood ( d = 0.345, BF = 39.048). The analysis pointed out that TPM could reduce anxiety ( d = 0.517, BF = 5.993). TPM’s efficacy in relieving alcohol withdrawal, minimizing relapse, and decreasing depressive symptoms was inconclusive. There was evidence of a meta-regression effect of attrition rate on heavy drinking days and craving and length of treatment on abstinence. Conclusion: TPM has the potential to become a key pharmacological agent in the treatment of AUD.
Source: Journal of Psychopharmacology
Institutions: Emory University, Emory University Hospital
Language: English
Subfield: Epidemiology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4316928630