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Standardized or weighted mean difference (SMD<\/jats:styled-content>\/WMD<\/jats:styled-content>), risk ratio (RR<\/jats:styled-content>) \u00b195% confidence intervals (CI<\/jats:styled-content>s), and number needed to harm (NNH<\/jats:styled-content>) were calculated.<\/jats:p><\/jats:sec>Results<\/jats:title>Across 16 RCT<\/jats:styled-content>s (n<\/jats:italic> = 934, duration = 11.8 \u00b1 5.6 weeks), topiramate outperformed the comparator regarding change\/endpoint of total (SMD<\/jats:styled-content>: \u22120.58, 95% CI<\/jats:styled-content>: \u22120.82, \u22120.35, P<\/jats:italic> < 0.00001), positive (SMD<\/jats:styled-content>: \u22120.37, 95% CI<\/jats:styled-content>: \u22120.61, \u22120.14, P<\/jats:italic> = 0.002), negative (SMD<\/jats:styled-content>: \u22120.58, 95% CI<\/jats:styled-content>: \u22120.87, \u22120.29, P<\/jats:italic> < 0.0001), and general symptoms (SMD<\/jats:styled-content>: \u22120.68, 95% CI<\/jats:styled-content>: \u22120.95, \u22120.40, P<\/jats:italic> < 0.00001). Furthermore, topiramate was superior regarding body weight (WMD<\/jats:styled-content>: \u20132.75 kg, 95% CI<\/jats:styled-content>: \u22124.03, \u22121.47, P<\/jats:italic> < 0.0001), body mass index (BMI<\/jats:styled-content>) (WMD<\/jats:styled-content>: \u20131.77, 95% CI<\/jats:styled-content>: \u22122.38, \u22121.15, P<\/jats:italic> < 0.00001), triglycerides (P<\/jats:italic> = 0.006), and insulin levels (P<\/jats:italic> < 0.00001). Superiority regarding psychopathology and body weight\/BMI<\/jats:styled-content> was consistent across Chinese\/Asian and Western RCT<\/jats:styled-content>s, double\u2010blind and open designs, clozapine and non\u2010clozapine cotreatment, augmentation and co\u2010initiation RCT<\/jats:styled-content>s, and higher and lower quality RCT<\/jats:styled-content>s. In meta\u2010regression analyses, topiramate's efficacy for total symptoms was moderated by shorter illness duration (P<\/jats:italic> = 0.047), while weight loss was greater in prevention\/co\u2010initiation vs. intervention\/augmentation RCT<\/jats:styled-content>s (\u22124.11 kg, 95% CI<\/jats:styled-content>: \u22126.70, \u22121.52 vs. \u22121.41 kg, 95% CI<\/jats:styled-content>: \u22122.23, \u22120.59, P<\/jats:italic> < 0.001). All\u2010cause discontinuation was similar between topiramate and comparators (RR: 1.28, 95% CI: 0.91, 1.81, P<\/jats:italic> = 0.16). While topiramate led to more concentration\/attention difficulties (P<\/jats:italic> = 0.03, NNH<\/jats:styled-content> = 8, 95% CI<\/jats:styled-content>=4\u201325), psychomotor slowing (P<\/jats:italic> = 0.02, NNH<\/jats:styled-content> = 7, 95% CI<\/jats:styled-content> = 4\u201325), and paresthesia (P<\/jats:italic> = 0.05, NNH<\/jats:styled-content> = 2, 95% CI<\/jats:styled-content> = 4\u201333), it led to less \u22657% weight gain (P<\/jats:italic> = 0.0001, NNH<\/jats:styled-content> = 2, 95% CI<\/jats:styled-content> = 2\u20133) and constipation (P<\/jats:italic> = 0.04, NNH<\/jats:styled-content> = 9, 95% CI<\/jats:styled-content> = 5\u2013100) than the comparator.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>These results indicate that adjunctive topiramate to antipsychotics is an effective and safe treatment choice for symptomatic improvement and weight reduction in patients with schizophrenia\u2010spectrum disorders.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acps.12631","type":"journal-article","created":{"date-parts":[[2016,9,2]],"date-time":"2016-09-02T02:52:55Z","timestamp":1472784775000},"page":"385-398","source":"Crossref","is-referenced-by-count":57,"title":["Efficacy and safety of adjunctive topiramate for schizophrenia: a meta\u2010analysis of randomized controlled trials"],"prefix":"10.1111","volume":"134","author":[{"given":"W.","family":"Zheng","sequence":"first","affiliation":[{"name":"The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital) Guangzhou China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.\u2010T.","family":"Xiang","sequence":"additional","affiliation":[{"name":"The National Clinical Research Center for Mental Disorders China & Beijing Anding Hospital Capital Medical University Beijing China"},{"name":"Unit of Psychiatry Faculty of Health Sciences University of Macau Macao China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.\u2010Q.","family":"Xiang","sequence":"additional","affiliation":[{"name":"Beijing Anding Hospital Capital Medical University Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"X.\u2010B.","family":"Li","sequence":"additional","affiliation":[{"name":"Beijing Anding Hospital Capital Medical University Beijing China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. 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