Andrus MR, Gilbert E. Treatment of civilian and combat-related posttraumatic stress disorder with topiramate.
Ann Pharmacother 2010;
44:1810-6. [PMID:
20923947 DOI:
10.1345/aph.1p163]
[Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE
To evaluate the use of topiramate for the treatment of posttraumatic stress disorder (PTSD).
DATA SOURCES
Ovid MEDLINE (1950 to June week 4, 2010), International Pharmaceutical Abstracts (1970 to May 2010), ISI Web of Science (1945 to July 3, 2010), and Iowa Drug Information Service (searched July 6, 2010) were searched using the terms posttraumatic stress disorder and topiramate. Guidelines and other sources were identified from bibliography searches.
STUDY SELECTION AND DATA EXTRACTION
All English-language human studies and case reports that evaluated the use of topiramate for treatment of PTSD were evaluated.
DATA SYNTHESIS
One case report, 1 case series, 2 open-label trials, and 1 placebo-controlled trial that used topiramate (monotherapy or adjunct) to treat civilian PTSD were identified and evaluated. The case report and case series reported subjective reduction of symptoms, and the open-label trials reported a significant reduction in PTSD Checklist-Civilian score. The placebo-controlled trial found no significant difference in Clinician-Administered PTSD Scale (CAPS) score. One open-label trial and 2 placebo-controlled trials that used topiramate in combat-related PTSD were identified and evaluated. The open-label trial reported a significant reduction in CAPS score, and 1 placebo-controlled trial reported a statistically significant difference in CAPS score. However, the other placebo-controlled trial found no significant differences. In some of the trials evaluated, the clinical significance of outcomes reported is difficult to determine. Adverse effects were reported throughout the trials but generally were not considered serious.
CONCLUSIONS
Based on the limited evidence available, topiramate is a possible alternative or adjunct option for patients with PTSD that is refractory to standard treatments.
Collapse