Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Feb 24:6:14.
doi: 10.18332/tpc/115167. eCollection 2020.

Topiramate for smoking cessation: Systematic review and meta-analysis

Nesma Lotfy  1 , Hozaifa Elsawah  1 , Mona Hassan  1
Affiliations

Topiramate for smoking cessation: Systematic review and meta-analysis

Nesma Lotfy et al. Tob Prev Cessat. .

Abstract

Introduction: Topiramate is an antiepileptic drug that has been used for many labeled and off-labeled indications. It may be useful in reducing withdrawal symptoms of various addictive agents such as alcohol, cocaine, cannabis and smoking. To date, some studies have examined the effectiveness of topiramate for smoking cessation. The present review aims to synthesize the results from those studies and determine topiramate effectiveness in smoking cessation.

Methods: A comprehensive search was conducted in the databases: PubMed/Medline, Cochrane, Egyptian Knowledge Bank, and Google Scholar. All clinical trials that examined the effect of topiramate, compared with the placebo, on smoking cessation rate were included. Statistical analysis using fixed effect models, heterogeneity and sensitivity analysis were conducted using RevMan 5.3.

Results: Five trials met the inclusion criteria and were included in the meta-analysis. Topiramate non-significantly increased prolonged smoking abstinence rate (OR=1.19, 95% CI: 0.57-2.5) compared with the placebo. On the other hand, topiramate significantly increased the abstinence rate at weeks 4, 6, 8 and 12 (OR=3.07, 95% CI: 1.19-7.93; OR=4.03, 95% CI: 1.98-8.2; OR=2.29, 95% CI: 1.23-4.28; and OR=2.45, 95% CI: 1.37-4.39; respectively) compared with the placebo.

Conclusions: Based on the five trials, where publication bias cannot be excluded, the current evidence is not sufficient to show a significant difference to favor topiramate in prolonged smoking cessation over the placebo, although the 12th week point prevalence favored topiramate.

Keywords: abstinence rate; meta-analysis; smoking cessation; topiramate.

PubMed Disclaimer

Conflict of interest statement

The authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest and none was reported.

Figures

Figure 1
Figure 1
PRISMA flow diagram for identification and screening of studies
Figure 2
Figure 2
Forest plot for 4-week smoking abstinence rate
Figure 3
Figure 3
Forest plot for all time-points meta-analysis (ATM) of smoking abstinence rate
Figure 4
Figure 4
Sensitivity analysis for all time-points meta-analysis (ATM) of smoking abstinence rate after excluding the low-quality study
See this image and copyright information in PMC

References

    1. Mokdad AH, Marks JS, Stroup DF, Gerberding JL. Actual causes of death in the United States, 2000. JAMA. 2004;291(10):1238–1245. doi: 10.1001/jama.291.10.1238. - DOI - PubMed
    1. National Center for Chronic Disease Prevention and Health Promotion (US) Office on Smoking and Health . The health consequences of smoking—50 years of progress: a report of the Surgeon General. Atlanta (GA: Centers for Disease Control and Prevention (US); 2014. - DOI - PubMed
    1. Langtry HD, Gillis JC, Davis R. Topiramate. Drugs. 1997;54(5):752–773. doi: 10.2165/00003495-199754050-00009. - DOI - PubMed
    1. Marcotte D. Use of topiramate, a new anti-epileptic as a mood stabilizer. J Affect Disord. 1998;50(2-3):245–251. doi: 10.1016/s0165-0327(98)00110-4. - DOI - PubMed
    1. Appolinario JC, Fontenelle LF, Papelbaum M, Bueno JR, Coutinho W. Topiramate use in obese patients with binge eating disorder: an open study. Can J Psychiatry. 2002;47(3):271–273. doi: 10.1177/070674370204700309. - DOI - PubMed

LinkOut - more resources