Efficacy and tolerability of topiramate-augmentation therapy for schizophrenia: a systematic review and meta-analysis of randomized controlled trials

Yuji Okuyama,* Kazuto Oya,* Shinji Matsunaga, Taro Kishi, Nakao Iwata Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan *These authors contributed equally to this work Abstract: This study aimed to perform a comprehensive meta-analysis of topiramate-augmen&...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Okuyama Y, Oya K, Matsunaga S, Kishi T, Iwata N
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2016
Materias:	schizophrenia topiramate efficacy safety systematic review meta-analysis Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
Acceso en línea:	https://doaj.org/article/eb520151a6464b2a9c6e68e48718e36a
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:eb520151a6464b2a9c6e68e48718e36a
record_format	dspace
spelling	oai:doaj.org-article:eb520151a6464b2a9c6e68e48718e36a2021-12-02T04:03:29ZEfficacy and tolerability of topiramate-augmentation therapy for schizophrenia: a systematic review and meta-analysis of randomized controlled trials1178-2021https://doaj.org/article/eb520151a6464b2a9c6e68e48718e36a2016-12-01T00:00:00Zhttps://www.dovepress.com/efficacy-and-tolerability-of-topiramate-augmentation-therapy-for-schiz-peer-reviewed-article-NDThttps://doaj.org/toc/1178-2021Yuji Okuyama,* Kazuto Oya,* Shinji Matsunaga, Taro Kishi, Nakao Iwata Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan *These authors contributed equally to this work Abstract: This study aimed to perform a comprehensive meta-analysis of topiramate-augmentation therapy in patients with schizophrenia receiving antipsychotic agents. Data published up to June 20, 2016 were obtained from the PubMed, PsycINFO, and Cochrane Library databases. Twelve randomized controlled trials comparing topiramate to placebo or antipsychotic only were included (n=676 patients). The primary outcome was change in overall symptoms. Relative risk (RR) and standardized mean difference (SMD), along with 95% confidence intervals, were calculated using random effects model for each outcome. Topiramate-augmentation therapy was superior to the control for decreasing overall symptoms (SMD -0.55, 95% confidence interval -0.86 to -0.24; P=0.001; I2=55%, eight comparisons, n=380), positive symptoms (SMD -0.4), negative symptoms (SMD -0.47), and Positive and Negative Syndrome Scale general subscale scores (SMD -0.67). Furthermore, topiramate-augmentation therapy decreased weight (SMD -0.69) and body mass index (SMD -0.95) compared with the control. Topiramate was similar to the control with respect to discontinuation due to all causes (RR 1.19), inefficacy (RR 1.71), and adverse events (RR 1.09). Topiramate was associated with higher incidence of paresthesia (RR 2.67) and attention difficulty (RR 8.97) compared with the control. Our results seemed to suggest that topiramate-augmentation therapy improves the psychopathology of schizophrenia with good tolerability and has the additional advantage of weight maintenance. However, because there were some limitations (numbers of studies and patients included in the meta-analysis were small, some studies used completer analysis, Chinese studies were included in the meta-analysis, and studies that had a risk of bias were included in the meta-analysis) in this study, we cannot apply the results of this study in daily clinical practice. Keywords: schizophrenia, topiramate, efficacy, safety, systematic review, meta-analysisOkuyama YOya KMatsunaga SKishi TIwata NDove Medical Pressarticleschizophreniatopiramateefficacysafetysystematic reviewmeta-analysisNeurosciences. Biological psychiatry. NeuropsychiatryRC321-571Neurology. Diseases of the nervous systemRC346-429ENNeuropsychiatric Disease and Treatment, Vol Volume 12, Pp 3221-3236 (2016)
institution	DOAJ
collection	DOAJ
language	EN
topic	schizophrenia topiramate efficacy safety systematic review meta-analysis Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429
spellingShingle	schizophrenia topiramate efficacy safety systematic review meta-analysis Neurosciences. Biological psychiatry. Neuropsychiatry RC321-571 Neurology. Diseases of the nervous system RC346-429 Okuyama Y Oya K Matsunaga S Kishi T Iwata N Efficacy and tolerability of topiramate-augmentation therapy for schizophrenia: a systematic review and meta-analysis of randomized controlled trials
description	Yuji Okuyama,* Kazuto Oya,* Shinji Matsunaga, Taro Kishi, Nakao Iwata Department of Psychiatry, Fujita Health University School of Medicine, Toyoake, Japan *These authors contributed equally to this work Abstract: This study aimed to perform a comprehensive meta-analysis of topiramate-augmentation therapy in patients with schizophrenia receiving antipsychotic agents. Data published up to June 20, 2016 were obtained from the PubMed, PsycINFO, and Cochrane Library databases. Twelve randomized controlled trials comparing topiramate to placebo or antipsychotic only were included (n=676 patients). The primary outcome was change in overall symptoms. Relative risk (RR) and standardized mean difference (SMD), along with 95% confidence intervals, were calculated using random effects model for each outcome. Topiramate-augmentation therapy was superior to the control for decreasing overall symptoms (SMD -0.55, 95% confidence interval -0.86 to -0.24; P=0.001; I2=55%, eight comparisons, n=380), positive symptoms (SMD -0.4), negative symptoms (SMD -0.47), and Positive and Negative Syndrome Scale general subscale scores (SMD -0.67). Furthermore, topiramate-augmentation therapy decreased weight (SMD -0.69) and body mass index (SMD -0.95) compared with the control. Topiramate was similar to the control with respect to discontinuation due to all causes (RR 1.19), inefficacy (RR 1.71), and adverse events (RR 1.09). Topiramate was associated with higher incidence of paresthesia (RR 2.67) and attention difficulty (RR 8.97) compared with the control. Our results seemed to suggest that topiramate-augmentation therapy improves the psychopathology of schizophrenia with good tolerability and has the additional advantage of weight maintenance. However, because there were some limitations (numbers of studies and patients included in the meta-analysis were small, some studies used completer analysis, Chinese studies were included in the meta-analysis, and studies that had a risk of bias were included in the meta-analysis) in this study, we cannot apply the results of this study in daily clinical practice. Keywords: schizophrenia, topiramate, efficacy, safety, systematic review, meta-analysis
format	article
author	Okuyama Y Oya K Matsunaga S Kishi T Iwata N
author_facet	Okuyama Y Oya K Matsunaga S Kishi T Iwata N
author_sort	Okuyama Y
title	Efficacy and tolerability of topiramate-augmentation therapy for schizophrenia: a systematic review and meta-analysis of randomized controlled trials
title_short	Efficacy and tolerability of topiramate-augmentation therapy for schizophrenia: a systematic review and meta-analysis of randomized controlled trials
title_full	Efficacy and tolerability of topiramate-augmentation therapy for schizophrenia: a systematic review and meta-analysis of randomized controlled trials
title_fullStr	Efficacy and tolerability of topiramate-augmentation therapy for schizophrenia: a systematic review and meta-analysis of randomized controlled trials
title_full_unstemmed	Efficacy and tolerability of topiramate-augmentation therapy for schizophrenia: a systematic review and meta-analysis of randomized controlled trials
title_sort	efficacy and tolerability of topiramate-augmentation therapy for schizophrenia: a systematic review and meta-analysis of randomized controlled trials
publisher	Dove Medical Press
publishDate	2016
url	https://doaj.org/article/eb520151a6464b2a9c6e68e48718e36a
work_keys_str_mv	AT okuyamay efficacyandtolerabilityoftopiramateaugmentationtherapyforschizophreniaasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT oyak efficacyandtolerabilityoftopiramateaugmentationtherapyforschizophreniaasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT matsunagas efficacyandtolerabilityoftopiramateaugmentationtherapyforschizophreniaasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT kishit efficacyandtolerabilityoftopiramateaugmentationtherapyforschizophreniaasystematicreviewandmetaanalysisofrandomizedcontrolledtrials AT iwatan efficacyandtolerabilityoftopiramateaugmentationtherapyforschizophreniaasystematicreviewandmetaanalysisofrandomizedcontrolledtrials
_version_	1718401465402261504

Efficacy and tolerability of topiramate-augmentation therapy for schizophrenia: a systematic review and meta-analysis of randomized controlled trials

Ejemplares similares