Topiramate in the treatment of alcohol dependence: a meta-analysis.

UNLABELLED: Several controlled clinical trials have studied the efficacy of topiramate in the treatment of alcoholism. In this paper, we have performed a meta-analysis of those trials in which topiramate was compared with placebo and then we reviewed its efficacy in trials in which it was compared with other drugs. METHOD: A quantitative synthesis of data was per-formed using inverse variance weighting in a random effects model. RESULTS: Based on three placebo-controlled trials, topiramate is more efficacious than placebo in reducing the percentage of heavy drinking days (23.2%, 95% confidence interval [CI]: 15.7 to 34.4), increasing the number of days of abstinence (mean difference: 2.9 days, 95% CI: 2.5 to 3.3),and lowering the logarithm of g-GT levels (mean difference:0.075 95% CI: 0.048 to 0.118). Two trials suggested that topiramate is also more efficacious than naltrexone, and one open-label study reported better results for disulfiram than for topiramate. CONCLUSION: Topiramate can be used in alcohol dependence. Adverse effects such as paresthesia or insomnia should be taken into account when prescribing topiramate.Its optimal dosage requires further research.

Topiramato en el tratamiento de la dependencia etílica: un metaanálisis / Topiramate in the treatment of alcohol dependence: a meta-analysis

Introducción. Algunos ensayos clínicos controlados han estudiado la eficacia del topiramato para el tratamiento del alcoholismo. En este artículo, primero realizamos un meta análisis de los ensayos donde el topiramato era comparado con el placebo, y después revisamos la eficacia en los ensayos donde era comparado con otros fármacos. Método. Una síntesis cuantitativa de los datos se llevó acabo ponderando por el inverso de la varianza en un modelo de efectos aleatorios. Resultados. En base a tres ensayos clínicos controlados, el topiramato es más eficaz que el placebo en: reducción del porcentaje de los días de consumo elevado (23,2%, intervalo de confianza [IC] del 95%: 15,7 a 34,4), incremento del número de días de abstinencia (diferencia media: 2,9 días, IC del 95%: 2,5 a 3,3) y descenso del logaritmo de los niveles de epsilon-GT (diferencia media: 0,075, IC del 95%: 0,048 a 0,118).Dos ensayos sugirieron que el topiramato es también más eficaz que la naltrexona y un estudio abierto refirió mejores resultados para el disulfirán que para el topiramato. Conclusiones. El topiramato puede ser utilizado para el tratamiento en la dependencia etílica; los efectos adversos tales como las parestesias o el insomnio deben ser tenidos en cuenta cuando se prescribe topiramato. La dosis óptima precisa investigación adicional (AU)

Introduction. Several controlled clinical trials have studied the efficacy of topiramate in the treatment of alcohol dependence: a metaanalysis Introduction. Several controlled clinical trials have studied the efficacy of topiramate in the treatment of alcoholism. In this paper, we have performed a metaanalysis of those trials in which topiramate was compared with placebo and then we reviewed its efficacy in trials in which it was compared with other drugs. Method. A quantitative synthesis of data was performed using inverse variance weighting in a random effects model. Results. Based on three placebo-controlled trials, topiramate is more efficacious than placebo in reducing the percentage of heavy drinking days (23.2%, 95% confidence interval [CI]: 15.7 to 34.4), increasing the number of days of abstinence (mean difference: 2.9 days, 95%CI: 2.5 to 3.3), and lowering the logarithm of g-GT levels(mean difference: 0.075 95% CI: 0.048 to 0.118). Two trials suggested that topiramate is also more efficacious than naltrexone, and one open-label study reported better results for disulfiram than for topiramate. Conclusion. Topiramate can be used in alcohol dependence. Adverse effects such as paresthesia or insomnia should be taken into account when prescribing topiramate. Its optimal dosage requires further research (AU)

Quality of reporting controlled clinical trials on treatment of the acute mania phase of bipolar disorder with new antipsychotic drugs.

The main goal in this paper is to describe how articles on clinical trials on atypical antipsychotic drugs in bipolar disorder reported their design. 25 controlled clinical trials were identified. Data were extracted on the general characteristics of the studies, including sources of funding, study design, and ethical issues. Most trials adequately report design issues such as patient selection, randomization, and flow of patients. However, only 8 of 25 studies reported pre-estimation of sample size; 22 articles claimed a double-blind design, but only 3 reported details on how blinding was performed; 17 trials failed to explicitly adhere to the Declaration of Helsinki.