Effects of topiramate: A Synthesis of Findings from 13 Studies

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Original Abstract of the Article

Major Research Findings

Topiramate is an anti-epileptic drug (AED) with various effects investigated in numerous studies. 1 provides practical recommendations for using topiramate in epilepsy patients, including dosage adjustments, managing side effects, withdrawal of concomitant AEDs, and patient counseling. 9 suggests that topiramate can alter brain wave patterns and potentially affect alertness in healthy individuals, highlighting its potential neurotoxic effects. 3 compares topiramate to valproate in terms of cognitive effects, exploring the potential for gradual introduction to improve tolerability and prevent cognitive impairment. 6 investigates the cognitive and behavioral effects of topiramate compared to lamotrigine, indicating that lamotrigine may have fewer adverse effects on cognitive function. 11 analyzes multiple studies on topiramate's efficacy in weight loss, suggesting its potential as an adjunctive therapy. 12 investigates the brain's compensatory mechanisms in response to topiramate-induced cognitive impairment. 7 explores the potential of topiramate in combination with nicotine for smoking cessation in alcohol-dependent individuals. 10 explores topiramate's effects on cue-induced cigarette craving and the response to smoking, suggesting that it might enhance both withdrawal and reward, raising questions about its effectiveness in smoking cessation. 4 compares the cognitive and behavioral effects of topiramate and valproate, indicating that topiramate might have slightly worse cognitive effects compared to valproate. 2 investigates the cognitive effects of topiramate, gabapentin, and lamotrigine, suggesting that topiramate has potential for acute and steady-state adverse cognitive effects compared to the other two drugs. 5 compares the cognitive effects of topiramate and gabapentin, finding that topiramate significantly impaired cognitive performance compared to gabapentin. 13 explores topiramate's effects on the association between mood, cannabis craving, and cannabis use in young individuals. 8 investigates the kinetic and cardiovascular effects of topiramate in methamphetamine-dependent individuals, finding that it appears safe at pharmacologically relevant doses.

Benefits and Risks

Benefit Summary

Topiramate is effective in treating epilepsy and might have potential as an adjunctive therapy for weight loss. 1 11

Risk Summary

Topiramate can potentially have adverse effects on cognitive function, mood, sleep, and appetite. 9 3 6 4 2 5 Additionally, it might increase nicotine craving in smokers. 10

Comparison of Studies

Commonalities among Studies

Many studies indicate that topiramate can have adverse effects on cognitive function. 9 3 6 4 2 5 Moreover, these studies suggest that topiramate might have a higher risk of adverse cognitive effects compared to other AEDs. 3 6 4 2 5

Differences among Studies

The effects of topiramate can vary based on factors such as dosage, duration of treatment, and individual patient characteristics, leading to diverse outcomes in different studies.

Consistency and Contradictions in Results

While topiramate is an effective treatment for epilepsy, evidence suggests potential negative impacts on cognitive function. 1 9 3 6 4 2 5 These contradictions highlight the potential for significant variability in topiramate's effects based on individual patient factors.

Considerations for Real-World Application

When considering topiramate, it is essential to be aware of its potential for cognitive side effects. 9 3 6 4 2 5 Activities requiring concentration and attention, such as driving or operating machinery, should be approached with caution. Topiramate's potential for weight loss is another factor to consider, but its effectiveness and side effect profile can vary. 11 Consultation with a healthcare professional is crucial to determine appropriate dosage and treatment plans based on individual needs and circumstances.

Limitations of Current Research

The existing research on topiramate is not exhaustive and further investigation is required. 1 9 3 6 11 12 7 10 4 2 5 13 8

Future Research Directions

To gain a deeper understanding of topiramate's effects, further research is needed, considering factors such as dosage, treatment duration, and individual patient variations. 1 9 3 6 11 12 7 10 4 2 5 13 8 Additional research is also crucial to explore how topiramate interacts with other medications.

Conclusion

Topiramate is an effective anti-epileptic drug but can have potential adverse cognitive effects. 1 9 3 6 4 2 5 If you are considering topiramate, it is crucial to consult with your doctor to determine the most appropriate dosage and treatment plan for your individual circumstances. If you experience any cognitive issues while taking topiramate, consult your healthcare provider.

Literature analysis of 13 papers
Positive Content
9
Neutral Content
2
Negative Content
2
Article Type
11
2
0
1
13
1.

Practical aspects of the use of topiramate in patients with epilepsy.

Author: SanderJ W

Epilepsy treatment
Side effects

Topiramate is a new antiepileptic drug that can be used to treat epilepsy. Recommendations for optimal utilization of topiramate include dosage titration guidelines, options for managing side effects occurring early in treatment, advice concerning the withdrawal of concomitant AEDs, indications for discontinuation of TPM, and recognition of the need for adequate patient counseling.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.

Language : English

2.

Cognitive effects of topiramate, gabapentin, and lamotrigine in healthy young adults.

Author: MartinR, KuznieckyR, HoS, HetheringtonH, PanJ, SinclairK, GilliamF, FaughtE

Tolerable AEDs
Cognitive effects

Topiramate had significant adverse cognitive effects in healthy adults, while gabapentin and lamotrigine had minimal effects.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

3.

A multicenter, randomized clinical study to evaluate the effect on cognitive function of topiramate compared with valproate as add-on therapy to carbamazepine in patients with partial-onset seizures.

Author: AldenkampA P, BakerG, MulderO G, ChadwickD, CooperP, DoelmanJ, DuncanR, Gassmann-MayerC, de HaanG J, HughsonC, HulsmanJ, OverwegJ, PledgerG, RentmeesterT W, RiazH, WroeS

Improved tolerability
Prevents cognitive impairment

Topiramate and valproate, two anticonvulsant medications, were compared for their cognitive effects when used as adjunctive therapy to carbamazepine. The study found that a more gradual introduction of topiramate improved tolerability and prevented cognitive impairment.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

4.

Differential cognitive and behavioral effects of topiramate and valproate.

Author: MeadorK J, LoringD W, HulihanJ F, KaminM, KarimR,

Cognitive improvement
Cognitive impairment

Topiramate (TPM) and valproate (VPA) had comparable cognitive effects when added to carbamazepine (CBZ) in adults with partial seizures. However, TPM was associated with slightly worse cognitive effects overall, particularly in a small subset of patients. The cognitive effects of TPM were more pronounced at the end of titration than at the end of maintenance.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Multicenter StudyResearch conducted in collaboration with multiple research institutions. It aims to collect a wide range of data and obtain more generalizable results.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Effects of topiramate and gabapentin on cognitive abilities in healthy volunteers.

Author: SalinskyM C, StorzbachD, SpencerD C, OkenB S, LandryT, DodrillC B

Gabapentin tolerability
Cognitive impairment

Topiramate significantly impaired cognitive performance in healthy volunteers, while gabapentin had minimal effects, suggesting that topiramate may affect daily and occupational function.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Cognitive and behavioral effects of lamotrigine and topiramate in healthy volunteers.

Author: MeadorK J, LoringD W, VahleV J, RayP G, WerzM A, FesslerA J, OgrockiP, SchoenbergM R, MillerJ M, KustraR P

Improved behavioral effects
Improved cognitive function

Lamotrigine produced fewer untoward cognitive and behavioral effects compared to topiramate in healthy adults. This suggests that lamotrigine might be a better choice for patients who are concerned about cognitive function.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Effects of topiramate in combination with intravenous nicotine in overnight abstinent smokers.

Author: SofuogluMehmet, PolingJames, MouratidisMaria, KostenThomas

Alcohol addiction treatment
Cocaine addiction treatment
Smoking cessation

This study explores the effects of topiramate on tobacco addiction.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

8.

Kinetic and cardiovascular effects of acute topiramate dosing among non-treatment-seeking, methamphetamine-dependent individuals.

Author: JohnsonBankole A, WellsLynda T, RoacheJohn D, WallaceChristopher L, Ait-DaoudNassima, DawesMichael A, LiuLei, WangXin-Qun, JavorsMartin A

Methamphetamine dependence treatment
Safe drug combination

Topiramate did not alter the kinetic profile or hemodynamic response to methamphetamine in methamphetamine-dependent individuals.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

9.

Topiramate effects on the EEG and alertness in healthy volunteers: a different profile of antiepileptic drug neurotoxicity.

Author: SalinskyMartin, StorzbachDaniel, OkenBarry, SpencerDavid

topiramate EEG effects

This study investigated the effects of topiramate (TPM) on quantitative EEG (QEEG) and drowsiness. The hypothesis was that TPM would induce significant slowing of EEG background rhythms and an increase in drowsiness on the awake maintenance task (AMT).

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

10.

Effects of topiramate on cue-induced cigarette craving and the response to a smoked cigarette in briefly abstinent smokers.

Author: ReidMalcolm S, PalamarJoseph, RaghavanSumithra, FlamminoFrank

Smoking cessation
Enhanced withdrawal
Increased cigarette reward

This study investigated the effects of topiramate treatment on abstinence-related nicotine withdrawal, cue-induced cigarette craving, and the acute effects of a smoked cigarette. The study found that topiramate enhances both nicotine withdrawal and reward, questioning the utility of topiramate treatment for smoking cessation.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

12.

Brain's compensatory response to drug-induced cognitive impairment.

Author: Babu Henry SamuelImmanuel, BarkleyChristopher, MarinoSusan E, WangChao, HanSahng-Min, BirnbaumAngela K, CibulaJean E, DingMingzhou

Cognitive side effects

This study investigated the cognitive effects of topiramate (TPM) on healthy volunteers. The study found that TPM significantly reduced performance on a working-memory task, particularly at higher memory loads. This suggests that TPM may have negative effects on working memory.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.

Language : English

13.

Effects of topiramate on the association between affect, cannabis craving, and cannabis use in the daily life of youth during a randomized clinical trial.

Author: EmeryNoah N, CarpenterRyan W, MeiselSamuel N, MirandaRobert

Reduced substance use

Topiramate, an anticonvulsant, is being studied for substance use disorders. It is thought to reduce substance use by attenuating craving and reward effects. This paper explores whether topiramate attenuates the association of affect and craving with substance use.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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