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Efficacy and safety of topiramate in binge eating disorder: a systematic review and meta-analysis

Published online by Cambridge University Press:  09 July 2020

Mikail Nourredine ,
Lucie Jurek ,
Marine Auffret ,
Sylvain Iceta Open the ORCID record for Sylvain Iceta [Opens in a new window] ,
Guillaume Grenet ,
Behrouz Kassai ,
Michel Cucherat  and
Benjamin Rolland Open the ORCID record for Benjamin Rolland [Opens in a new window]
Mikail Nourredine*
Affiliation:
Department of Addictology, Centre Hospitalier Le Vinatier, Bron, France Department of Public Health, Hospices Civils de Lyon, Lyon, France
Lucie Jurek
Affiliation:
Department of Human Biology, Université Lyon 1, Lyon, France
Marine Auffret
Affiliation:
Department of Public Health, Hospices Civils de Lyon, Lyon, France
Sylvain Iceta
Affiliation:
Department of Endocrinology and nutrition, Hospices Civils de Lyon, Lyon, France Department of Nutrition, Laval university, Québec City, Québec, Canada
Guillaume Grenet
Affiliation:
Department of Public Health, Hospices Civils de Lyon, Lyon, France
Behrouz Kassai
Affiliation:
Department of Clinical Epidemiology, Hospices Civils de Lyon, Bron, France Department of Biostatistic, Université Lyon 1, Lyon, France
Michel Cucherat
Affiliation:
Department of Public Health, Hospices Civils de Lyon, Lyon, France Department of Biostatistic, Université Lyon 1, Lyon, France
Benjamin Rolland
Affiliation:
Department of Addictology, Centre Hospitalier Le Vinatier, Bron, France Centre de Recherche en Neurosciences de Lyon, Bron, France
*
Author for correspondence: Mikail Nourredine, Email: [email protected]
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Abstract

Background

To assess the efficacy and safety of topiramate in treating binge eating disorder (BED), using a systematic review and meta-analysis of the available randomized clinical trials (RCTs).

Methods

The RCTs assessing topiramate vs placebo with or without adjunctive psychotherapy in BED were reviewed using a systematic search in the PubMed, Web of Science, PsycINFO, Cochrane Database of Systematic Review, and ClinicalTrials.gov search Websites, from inception to November 2019. Main outcomes were the changes in binge frequency, quality of life, and weight, respectively. Effect estimates were pooled using random-effect models and presented as risk ratios (RRs) or mean differences (MDs) and their 95% confidence interval (95% CI). Data extraction was performed by two independent reviewers.

Results

Three studies were eligible for inclusion, involving 528 BED patients. Topiramate was found to be significantly more efficacious than placebo in reducing: (a) the number of binge episodes per week (MD = −1.31; 95% CI = −2.58 to −0.03; I2 = 94%); (b) the number of binge days per week (MD = −0.98; 95% CI = −1.80 to −0.16; I2 = 94%); and (c) weight (MD = −4.91 kg; 95% CI = −6.42 to −3.41; I2 = 10%). However, participants in the topiramate groups withdrew significantly more frequently for safety reasons, relative to placebo participants (RR = 1.90; 95% CI = 1.13-3.18, I2 = 0%).

Conclusions

Preliminary findings support a possible efficacy of topiramate for the treatment of BED, even if safety concerns could limit the practical use of this treatment in BED subjects.

Keywords

Topiramatebinge eatingdisordermeta-analysissystematic review
Type
Review
Information
CNS Spectrums , Volume 26 , Issue 5 , October 2021 , pp. 459 - 467
Copyright
© The Author(s), 2020. Published by Cambridge University Press

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