Meta-Analysis of Topiramate’s Effects for Individuals with Alcohol Use Disorders
Topiramate is a medication used to treat alcohol use disorders (AUD) in adults. It is thought to work by reducing cravings for alcohol through inhibiting the glutamate receptors and keeping dopamine from being released in the brain.
Blodgett and colleagues focuses on abstinence and heavy drinking outcomes, as well as cravings and the biomarker γ-glutamyltranspeptidase (GGT) by performing a review and subsequent meta-analysis.
This review included 7 randomized controlled trials with 1,125 participants. There was an average of 161 participants per study and most studies were 3 months long and had a target dose of 300 mg of topiramate. Additionally, four of the studies required individuals to complete a period of abstinence before participating in the trail.
The overall effect for topiramate for the treatment of AUDs is moderate for abstinence, heavy drinking, cravings and GGT outcomes, although its effect on cravings was not statistically significant.
The largest effect was found on abstinence, followed by heavy drinking and then GGT. The effect measured for abstinence may reflect a reduction in frequency of drinking, e.g. more abstinent days, than an increase in complete abstinence. The authors thought that this may be happening because not all of the studies required participants to be abstinent before receiving treatment.
A limitation that the authors discuss is the limited number of studies available on this topic. The small sample size also did not allow for further examinations of other factors that may influence the effects of topiramate.
Overall, Topiramate does demonstrate benefits for abstinence and heavy drinking outcomes and this meta-analysis provides support for the efficacy of this medication.
Blodgett, J. C., Del Re, A. C., Maisel, N. C., & Finney, J. W. (2014). A Meta‐Analysis of Topiramate’s Effects for Individuals with Alcohol Use Disorders. Alcoholism: Clinical and Experimental Research, 38(6), 1481-1488.