Efficacy of topiramate in reducing second‐generation antipsychotic‐associated weight gain among children: A systematic review and meta‐analysis
Aims To conduct a systematic review and meta‐analysis with the aim of synthesizing existing data on the efficacy and safety of topiramate as an adjunctive treatment for reducing second‐generation antipsychotic (SGA)‐associated weight gain in children aged 4–18 years. Methods We conducted a comprehen...
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Published in | Diabetes, obesity & metabolism Vol. 26; no. 6; pp. 2292 - 2304 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Oxford, UK
Blackwell Publishing Ltd
01.06.2024
Wiley Subscription Services, Inc |
Subjects | |
Online Access | Get full text |
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Summary: | Aims
To conduct a systematic review and meta‐analysis with the aim of synthesizing existing data on the efficacy and safety of topiramate as an adjunctive treatment for reducing second‐generation antipsychotic (SGA)‐associated weight gain in children aged 4–18 years.
Methods
We conducted a comprehensive search of PubMed, Embase, PsychNet and Web of Science from time of their inception up to 12 February 2024, including randomized controlled trials that compared SGA treatment with and without topiramate co‐administration in children. The primary outcomes were changes in body weight and body mass index (BMI). Heterogeneity was assessed using I2 statistics.
Results
This systematic review included five randomized trials, totalling 139 participants (43.9% female; mean [SD] age 11.9 [3.5] years). Four of these trials were included in the meta‐analysis, comprising 116 subjects. We found that topiramate was significantly effective both in reducing SGA‐associated weight gain, with a mean difference of −2.80 kg (95% confidence interval [CI] −5.28 to −0.31; p = 0.037, I2 = 86.7%) and a standardized mean difference (SMD) of −1.33 (95% CI −2.14 to −0.51; p = 0.014, I2 = 31.7%), and in reducing BMI change compared to placebo (SMD −1.90, 95% CI −3.09 to −0.70; p = 0.02, I2 = 0%). Sedation risk was lower with topiramate than with placebo (odds ratio 0.19, 95% CI 0.11–0.32; p < 0.01, I2 = 0%). No significant differences were found in dropouts, any other side effects, and metabolic parameters, such as triglycerides, total cholesterol, low‐density lipoprotein, high‐density lipoprotein, and glucose. None of the included studies reported assessments on cognitive side effects.
Conclusion
This meta‐analysis suggests that topiramate is an effective and safe option for mitigating SGA‐associated weight gain in children. |
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Bibliography: | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 ObjectType-Undefined-3 |
ISSN: | 1462-8902 1463-1326 |
DOI: | 10.1111/dom.15543 |