OBJECTIVE: To determine the effect of topiramate on patients with essential tremors in the randomized clinical trials
BACKGROUND: Essential tremor is characterized by an action tremor that occurs upon voluntary muscle contraction such as postural or kinetic tremor. Essential Tremor is a common movement disorder that interferes with the performance motor tasks and social activities. As a consequence, patients experience a reduction in quality of life. Topiramate is a broad spectrum antiepileptic drug with a good safety profile in humans. Topiramate has been reported to be effective in the management of essential tremors.
METHODS: Meta-analysis of two randomized trials searched from PUBMED/MEDLINE, Google and Cochrane Library (2001 up to present). Comparisons were performed according to intent-to-treat principle. Data were run through the RevMan 5 statistical software. Heterogeneity of Tremor Rating Scale outcome was assessed using Chi-square test statistics. The z-test statistic used to test the overall effect of the mean final TRS difference and mean change TRS difference between two treatments.
RESULTS: A total of 270 patients were included. Overall, the results showed that topiramate is effective in decreasing the Tremor Rating Scale score compared with placebo (CI 95%).
CONCLUSIONS: In summary, topiramate is better than the , placebo in reducing the Tremor Rating Scale score in this two randomized controlled trials. It showed that topiramate (n = 140) was significantly (p < 0.00001) more effective than placebo in improving TRS scores in patients with essential tremor.