Cochrane · systematic review · CD003384
Topiramate for acute affective episodes in bipolar disorder in adults
Pigott, K, Galizia, I, Vasudev, K, et al. · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
Common Mental DisordersAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
29
current version
GRADE rated
11
No studies
18
Included studies
NR
No studies 18 · 62.1%Ungraded 0 · 0%Very low 3 · 10.3%Low 6 · 20.7%Moderate 1 · 3.4%High 1 · 3.4%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Topiramate compared to placebo as monotherapy
Population: adults with acute affective episodes in bipolar disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Efficacy: change in scores from baseline to endpoint (3 weeks) on symptom rating scales in the treatment of manic and mixed episodes. Lower scores indicate improvement Topiramate vs placebo | no estimate extracted | 3 studies · 664 participants | Moderate Downgraded: imprecision |
Efficacy: change in scores from baseline to endpoint (12 weeks) on symptom rating scales in the treatment of manic and mixed episodes Lower scores indicate improvement Topiramate vs placebo | no estimate extracted | 1 study · 212 participants | Low Downgraded: imprecision |
Efficacy: change in scores from baseline to endpoint on symptom rating scales in the treatment of depressive episodes Topiramate vs placebo | no estimate extracted | NR | No studies |
Acceptability with topiramate (endpoint: 12 weeks) Number of participants experiencing troublesome side effects of any nature Topiramate vs placebo | OR 0.68 [0.33, 1.4] | 1 study · 212 participants | Low Downgraded: imprecision |
Response to treatment with topiramate. Number of participants experiencing a 50% reduction or greater in mean score from baseline to end of treatment on symptom rating scales in manic and mixed episodes Topiramate vs placebo | no estimate extracted | NR | No studies |
Response to treatment with topiramate. Number of participants experiencing a 50% reduction or greater in mean score from baseline to end of treatment on symptom rating scales in depressive episodes Topiramate vs placebo | no estimate extracted | NR | No studies |
Remission with topiramate. Number of participants presenting with a rating scale score within the normal range at the endpoint in manic and mixed episodes Topiramate vs placebo | no estimate extracted | NR | No studies |
Remission with topiramate. Number of participants presenting with a rating scale score within the normal range at the endpoint in depressive episodes Topiramate vs placebo | no estimate extracted | NR | No studies |
Topiramate as add‐on therapy compared to placebo as add‐on therapy for acute affective episodes in bipolar disorder
Population: adults with acute affective episodes in bipolar disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Efficacy: change in scores from baseline to endpoint (12 weeks) on symptom rating scales in the treatment of manic and mixed episodes Lower scores indicate improvement Topiramate as add‐on therapy vs placebo | no estimate extracted | 1 study · 287 participants | Low Downgraded: imprecision |
Efficacy: change in scores from baseline to endpoint on symptom rating scales in the treatment of depressive episodes Topiramate as add‐on therapy vs placebo | no estimate extracted | NR | No studies |
Acceptability with topiramate (endpoint: 12 weeks) Number of participants experiencing troublesome side effects of any nature Topiramate as add‐on therapy vs placebo | OR 1.1 [0.58, 2.1] | 1 study · 287 participants | Low Downgraded: imprecision |
Response to treatment with topiramate. Number of participants experiencing a 50% reduction or greater in mean score from baseline to end of treatment on symptom rating scales in manic and mixed episodes (endpoint: 12 weeks) Topiramate as add‐on therapy vs placebo | OR 0.98 [0.61, 1.58] | 1 study · 287 participants | Low Downgraded: imprecision |
Response to treatment with topiramate. Number of participants experiencing a 50% reduction or greater in mean score from baseline to end of treatment on symptom rating scales in depressive episodes Topiramate as add‐on therapy vs placebo | no estimate extracted | NR | No studies |
Remission with topiramate. Number of participants presenting with a rating scale score within the normal range at the endpoint in manic and mixed episodes Topiramate as add‐on therapy vs placebo | no estimate extracted | NR | No studies |
Remission with topiramate. Number of participants presenting with a rating scale score within the normal range at the endpoint in depressive episodes Topiramate as add‐on therapy vs placebo | no estimate extracted | NR | No studies |
Topiramate as monotherapy compared to an alternative drug as monotherapy for acute affective episodes in bipolar disorder
Population: adults with acute affective episodes in bipolar disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Efficacy: change in scores from baseline to endpoint (12 weeks) on symptom rating scales in the treatment of manic and mixed episodes Lower scores indicate improvement Topiramate as monotherapy vs an alternative drug | no estimate extracted | 2 studies · 449 participants | High |
Efficacy: change in scores from baseline to endpoint on symptom rating scales in the treatment of depressive episodes Topiramate as monotherapy vs an alternative drug | no estimate extracted | NR | No studies |
Acceptability with topiramate (12 weeks) Number of participants experiencing troublesome side effects of any nature Topiramate as monotherapy vs an alternative drug | OR 0.87 [0.5, 1.52] | 1 study · 230 participants | Low Downgraded: imprecision |
Response to treatment with topiramate. Number of participants experiencing a 50% reduction or greater in mean score from baseline to end of treatment on symptom rating scales in manic and mixed episodes Topiramate as monotherapy vs an alternative drug | no estimate extracted | NR | No studies |
Response to treatment with topiramate. Number of participants experiencing a 50% reduction or greater in mean score from baseline to end of treatment on symptom rating scales in depressive episodes Topiramate as monotherapy vs an alternative drug | no estimate extracted | NR | No studies |
Remission with topiramate. Number of participants presenting with a rating scale score within the normal range at the endpoint in manic and mixed episodes Topiramate as monotherapy vs an alternative drug | no estimate extracted | NR | No studies |
Remission with topiramate. Number of participants presenting with a rating scale score within the normal range at the endpoint in depressive episodes Topiramate as monotherapy vs an alternative drug | no estimate extracted | NR | No studies |
Topiramate as add‐on therapy compared to alternative drug as add‐on therapy for acute affective episodes in bipolar disorder
Population: people with acute affective episodes in bipolar disorder
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Efficacy: change in scores from baseline to endpoint on symptom rating scales in the treatment of manic and mixed episodes Topiramate as add‐on therapy vs alternative drug | no estimate extracted | NR | No studies |
Efficacy: change in scores from baseline to endpoint on symptom rating scales in the treatment of depressive episodes Topiramate as add‐on therapy vs alternative drug | no estimate extracted | NR | No studies |
Acceptability with topiramate (8 weeks) Number of participants experiencing troublesome side effects of any nature Topiramate as add‐on therapy vs alternative drug | OR 1.57 [0.42, 5.9] | 1 study · 36 participants | Very low Downgraded: risk of bias, imprecision |
Response to treatment with topiramate. Number of participants experiencing a 50% reduction or greater in mean score from baseline to end of treatment on symptom rating scales in manic and mixed episodes Topiramate as add‐on therapy vs alternative drug | no estimate extracted | NR | No studies |
Response to treatment with topiramate. Number of participants experiencing a 50% reduction or greater in mean score from baseline to end of treatment on symptom rating scales in depressive episodes (8 weeks) Topiramate as add‐on therapy vs alternative drug | OR 0.8 [0.21, 3] | 1 study · 36 participants | Very low Downgraded: risk of bias, imprecision |
Remission with topiramate as add‐on therapy. Number of participants presenting with a rating scale score within the normal range at the endpoint in manic and mixed episodes Topiramate as add‐on therapy vs alternative drug | no estimate extracted | NR | No studies |
Remission with topiramate. Number of participants presenting with a rating scale score within the normal range at the endpoint in depressive episodes (8 weeks) Topiramate as add‐on therapy vs alternative drug | OR 1 [0.23, 4.3] | 1 study · 36 participants | Very low Downgraded: imprecision |