title: [Topiramate in substance-related and addictive disorders].
abstract: BACKGROUND
  Drug treatments used in substance use disorders are not effective in all patients.
  
  
  OBJECTIVE
  To assess the effectiveness of topiramate use in the treatment of substance use disorders.
  
  
  METHODS
  Medline database from January 1966 to December 2013, Cochrane database and clinicaltrials.gov.
  
  
  METHODS
  We used keywords topiramate, addiction, substance abuse, alcohol, tobacco, nicotine, cocaine, methamphetamine, opiate, heroin, benzodiazepine, cannabis, bulimia nervosa, binge eating disorder, gambling. All clinical trials were included. Animal trials, laboratory tests, reviews, answers to writers, case-reports, case series and publications unrelated to the topic were excluded. Twenty-eight articles investigating the efficacy of topiramate in substance use were included.
  
  
  RESULTS
  In alcohol-related disorder, several trials and a meta-analysis showed a reduction of days of consumption. In a single-center trial on tobacco-related disorder, topiramate was not found effective in reducing the carbon monoxide expired. In cocaine-related disorder, one single-center trial showed a reduction of days of consumption and two single-center trials have found a trend in favour of topiramate. In alcohol and cocaine co-dependency, a single-center trial found a trend in favour of topiramate. In methamphetamine-related disorder, a multicenter trial found a trend in favour of topiramate. In bulimia nervosa, two single-center trials showed a reduction in binge eating and compensatory behaviours. In binge eating disorder, several trials showed a reduction of binge eating and weight. In gambling, one single-center trial did not show any significant results. There were no randomized controlled trials found in opioid-related disorder, benzodiazepines-related disorder, and cannabis-related disorder.
  
  
  CONCLUSIONS
  Definition of abstinence and methods to assess the efficacy of topiramate differed between trials. The methodological quality of included trials was variable, especially with no double-blind procedure in eight trials.
  
  
  CONCLUSIONS
  Topiramate showed interest mainly in alcoholism, binge eating disorder and bulimia nervosa. No definitive conclusions can be reached for other substance use disorders such as nicotine dependence, cocaine dependence, amphetamine dependence or cannabis dependence and for gambling.
authors.affiliation: Centre hospitalier Sainte-Anne, service d'addictologie du Dr X. Laqueille, 1, rue Cabanis, 75014 Paris, France. Electronic address: drjohancohen@gmail.com.
authors.forename: Johan
authors.initials: J
authors.lastname: Cohen
authors.affiliation: Centre hospitalier Sainte-Anne, service d'addictologie du Dr X. Laqueille, 1, rue Cabanis, 75014 Paris, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Dervaux
authors.affiliation: Centre hospitalier Sainte-Anne, service d'addictologie du Dr X. Laqueille, 1, rue Cabanis, 75014 Paris, France.
authors.forename: Xavier
authors.initials: X
authors.lastname: Laqueille
mesh_terms: D016739:Behavior, Addictive / Q000188:drug therapy*; D002986:Clinical Trials as Topic; D001068:Feeding and Eating Disorders / Q000188:drug therapy*; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005715:Gambling / Q000188:drug therapy; D006801:Humans; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D019966:Substance-Related Disorders / Q000188:drug therapy*; D000077236:Topiramate
chemical_list: D018696:Neuroprotective Agents; D000077236:Topiramate; D005632:Fructose