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Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet]. York (UK): Centre for Reviews and Dissemination (UK); 1995-.

Database of Abstracts of Reviews of Effects (DARE): Quality-assessed Reviews [Internet].

Efficacy and safety of topiramate on weight loss: a meta-analysis of randomized controlled trials

Review published: 2011.

Bibliographic details: Kramer CK, Leitao CB, Pinto LC, Canani LH, Azevedo MJ, Gross JL.  Efficacy and safety of topiramate on weight loss: a meta-analysis of randomized controlled trials. Obesity Reviews 2011; 12(501): e338-e347. [PubMed: 21438989]

Quality assessment

This generally well-conducted review found that topiramate may be a useful adjunctive treatment for obesity, and may play a role in the treatment of obesity in individuals with type 2 diabetes mellitus. The authors' conclusions are likely to be reliable. Full critical summary


Topiramate was associated with weight loss in clinical trials. We summarize the evidence on the efficacy and safety of topiramate in the treatment of overweight/obesity. The databases Medline, Embase, and Cochrane were searched. Randomized controlled studies with at least 16 weeks of duration that report the effect of topiramate on weight loss and adverse events were eligible for inclusion. Ten studies were included (3320 individuals). Patients treated with topiramate lost an average of 5.34 kg (95% confidence interval [95%CI]-6.12 to -4.56) of additional weight as compared with placebo. According to meta-regression analysis, treatment duration and dosage were associated with the efficacy of topiramate treatment. Evaluating trials using topiramate 96-200 mg day(-1) , the weight loss was higher in trials with >28 weeks of duration (-6.58 kg [95%CI -7.48 to -5.68]) than in trials with ≤28 weeks (-4.11 kg [95%CI -4.92 to -3.30]). Data of 6620 individuals were available for adverse events evaluation and those more frequently observed were paraesthesia, taste impairment and psychomotor disturbances. The odds ratio for adverse events leading to topiramate withdrawal was 1.94 (95%CI 1.64-2.29) compared with the control group. In conclusion, topiramate might be a useful adjunctive therapeutic tool in the treatment of obesity as long as proper warnings about side effects are considered.

© 2011 The Authors. obesity reviews © 2011 International Association for the Study of Obesity.

CRD has determined that this article meets the DARE scientific quality criteria for a systematic review.

Copyright © 2013 University of York.

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