A meta-analysis on the effect of topiramate in essential tremor

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

Oral pharmacological treatment of X-linked dystonia parkinsonism: Successes and failures

There is a paucity of published literature on the different oral medications tried for X-linked dystonia parkinsonism (XDP). In practice, most XDP patients are tired on medication typically used for patients with generalized dystonia. These drugs include anticholinergic agents, baclofen, clonazepam and other ben-zodiazepines, tetrabenazine, and clozapine. Although several articles have shown that these classess of drugs are beneficial for patients with generalized dystonia, none been systematically studied specifically for XDP patients. We are currently conducting the first randomized, placebo-controlled trial on the medications that have been used in XDP.