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    • "Le topiramate possède six mécanismes d'action principaux : agoniste GABA au niveau du site GABA-A ; antagoniste des récepteurs AMPA et kaïnate du glutamate ; inhibiteur des canaux calciques de type L et limitation des seconds messagers calcium-dépendants ; stabilisateur des membranes via les canaux sodium voltage-dépendants ; activateur de la conductance du potassium ; inhibiteur faible des iso-enzymes CA-II et CA-IV de l'anhydrase carbonique [6] [7]. Dans les addictions avec substances, une revue de la littérature sur l'efficacité du topiramate a été réalisée jusqu'en janvier 2009 [8]. "
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    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. Information sources Medline database from January 1966 to December 2013, Cochrane database and clinicaltrials.gov. Selection of studies 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. Limitations 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. Conclusion 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.
    La Presse Médicale 09/2014; 43(9). DOI:10.1016/j.lpm.2014.02.030 · 1.17 Impact Factor
    • "Le topiramate possède six mécanismes d'action principaux : agoniste GABA au niveau du site GABA-A ; antagoniste des récepteurs AMPA et kaïnate du glutamate ; inhibiteur des canaux calciques de type L et limitation des seconds messagers calcium-dépendants ; stabilisateur des membranes via les canaux sodium voltage-dépendants ; activateur de la conductance du potassium ; inhibiteur faible des iso-enzymes CA-II et CA-IV de l'anhydrase carbonique [6] [7]. Dans les addictions avec substances, une revue de la littérature sur l'efficacité du topiramate a été réalisée jusqu'en janvier 2009 [8]. "
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    ABSTRACT: Drug treatments used in substance use disorders are not effective in all patients.