A Bayesian meta-analysis of topiramate’s effectiveness for individuals with alcohol use disorder
Open accessAbstract
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.
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In a recent meta-analysis reviewing 13 RCTs comparing topiramate to placebo for AUD, topiramate demonstrated effectiveness in reducing heavy drinking days and weeks, decreasing alcohol craving, prolonging abstinence, and lowering gamma-glutamyl transferase levels, with potential benefits in reducing anxiety, but its efficacy in addressing AWS, preventing relapse, and reducing depressive symptoms,
“In a recent meta-analysis reviewing 13 RCTs comparing topiramate to a placebo for treating AUD, topiramate demonstrated effectiveness in reducing heavy drinking days and weeks, decreasing alcohol craving, prolonging abstinence, and lowering gamma-glutamyl transferase levels. The analysis also suggested potential benefits in reducing anxiety. However, its efficacy in addressing AWS, preventing”
From A Narrative Review of Current and Emerging Trends in the Treatment of Alcohol Use Disorder (2024) · cites this paper as [65]
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- Authors
- Fluyau, D., Kailasam, V. K., & Pierre, C. G.
- Affiliations
- Emory University (US)
- Interventional Pain Management, Northern Light Health, Brewer, ME, USA
- Emory University Hospital (US)
- Corresponding author
- Fluyau, Dimy
- Venue
- Journal of Psychopharmacology
- Publisher
- SAGE Publications
- Published
- 2023-01-17
- Volume
- 37
- Issue
- 2
- Pages
- 155-163
- ISSN
- 0269-8811 (ISSN-L)
- 1461-7285
- OpenAlex
- W4316928630
- Cited by
- 20
- References
- 59
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 9 · 2023: 4
- FWCI
- 0.78
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Psychopharmacology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Health Sciences › Medicine › Neurology › Alcoholism and Thiamine Deficiency
- Keywords
- topiramate, alcoholism, pharmacotherapy, heavy drinking days, alcohol craving, abstinence, gamma-glutamyl transferase, anxiety, attrition rates, relapse, depressive symptoms, alcohol withdrawal
- MeSH terms
- Topiramate, Alcohol Drinking, Alcoholism, Bayes Theorem, Humans, Substance Withdrawal Syndrome
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