Topiramate as add‐on treatment for patients with bipolar mania

Chengappa, KN Roy; Rathore, Dilip Singh; Levine, Joseph; Atzert, Rebecca; Solai, Lalith Kumar K.; Parepally, Haranath; Levin, Harry; Moffa, Nicolas; Delaney, Joyce; Brar, Jaspreet S.

doi:10.1034/j.1399-5618.1999.10111.x

Cited by 139 publications

(89 citation statements)

References 24 publications

(43 reference statements)

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“…In laboratory studies, TPM blocked the effects of kainite-induced excitatory conductance in cultured rat hippocampal neurons (Gibbs et al, 2000), and reduced the effects of hippocampal neuronal damage in gerbils caused by ischemia (Lee et al, 2000). These and other preclinical findings have provided a putative mechanism for the effects of TPM as an anticonvulsant (Jahromi et al, 2000;Shank et al, 2000), and are consistent with some clinical reports of the antiepileptic effects and mood-stabilizing effects of this compound (Chengappa et al, 1999;Jette et al, 2002;Privitera et al, 2003).…”

Section: Introductionsupporting

confidence: 79%

“…Diminished GR sensitivity has been associated with MDD (for a review see Pariante and Miller, 2001). That TPM might increase the sensitivity of GR is consistent with observed effects of this compound in mood disorders (Chengappa et al, 1999;Grunze et al, 2001;Carpenter et al, 2002). On the other hand, in some subjects, primarily those with PTSD whose pretreatment lysozyme IC 50 values were relatively low, TPM had the effect of reducing the sensitivity of the receptor, similar to what was observed in rats who demonstrated decreased mRNA expression following treatment with TPM.…”

Section: Discussionsupporting

confidence: 57%

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Effect of Topiramate on Glucocorticoid Receptor Mediated Action

Yehuda

Yang

Golier

et al. 2003

Neuropsychopharmacol

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This study examined the effects of topiramate (TPM) on glucocorticoid receptors (GRs) in mononuclear leukocytes of nine men and four women with chronic and recurring post-traumatic stress disorder (PTSD) and a group of comparison subjects (nine men, four women). A measure of 60 ml of blood was withdrawn by venipuncture at 0800 and mononuclear leukocytes were isolated. The cells were incubated with a series of concentrations of dexamethasone (DEX) without or with 50 mmol/l of TPM to evaluate the effects of DEX to inhibit lysozyme activity and the effect of TPM on it. ANCOVA compared the IC 50 for lysozyme inhibition under conditions of DEX only and TPM+DEX. TPM affected lysozyme IC 50 in the direction of increasing the sensitivity of the receptor in the sample as a whole. This effect was more pronounced in the mononuclear leukocytes from participants in the PTSD group, particularly in cells from subjects whose pretreatment lysozyme IC 50 was relatively higher (eg, reflecting decreased glucococorticoid receptor responsiveness), compared to the rest of the sample. In conclusion, further investigation of the actions of TPM on GR and other neuroendocrine systems may prove useful in understanding some of the other established clinical effects of this agent.

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Section: Introductionsupporting

confidence: 79%

Section: Discussionsupporting

confidence: 57%

Effect of Topiramate on Glucocorticoid Receptor Mediated Action

Yehuda

Yang

Golier

et al. 2003

Neuropsychopharmacol

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“…Topiramate is a currently marketed antiepileptic agent that has been shown to cause weight loss and improve insulin sensitivity in both humans (4,13) and animals (12,14). Our own studies have shown that Topiramate treatment in insulin-resistant female ZDF rats can lead to amelioration of insulin resistance independently of weight loss.…”

Section: Discussionmentioning

confidence: 91%

Topiramate treatment causes skeletal muscle insulin sensitization and increased Acrp30 secretion in high-fat-fed male Wistar rats

Wilkes¹,

Nguyen²,

Bandyopadhyay³

et al. 2005

American Journal of Physiology-Endocrinology and Metabolism

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“…[63][64][65][66] Rigorously performed, controlled trials, however, failed to find any benefit from use of this drug in bipolar disorder. 67 Topiramate has been commonly prescribed for patients with bipolar disorder, not only because of the expectation that it will prove to be efficacious, but also because of its weight-reducing effects, which are felt to be particularly desirable to counteract the weight gain induced by some other mood stabilizing agents (e.g., valproic acid).…”

Section: Topiramatementioning

confidence: 99%

Use of Antiepileptic Drugs for Nonepileptic Conditions: Psychiatric Disorders and Chronic Pain

2007

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Summary: Antiepileptic drugs (AEDs) are commonly utilized for nonepileptic conditions, including various psychiatric disorders and pain syndromes. Evidence for their benefit in these nonepileptic conditions varies widely among different drugs, but there is, in general, a paucity of published multicenter randomized double-blind trials. Variable levels of evidence suggest that lamotrigine and the vagal nerve stimulator have antidepressant properties. Carbamazepine, valproate, lamotrigine, and oxcarbazepine appear to have mood stabilizing properties while gabapentin, pregabalin, and tiagabine have anxiolytic benefits. Barbiturates, topiramate, and possibly phenytoin may precipitate or exacerbate depression. Underlying depression and anxiety symptoms may be exacerbated by levetiracetam, while psychotic symptoms have rarely been reported with topiramate, levetiracetam, and zonisamide. Pregabalin, gabapentin, carbamazepine, and oxcarbazepine have been used to treat neuropathic pain such as postherpetic neuralgia, and diabetic polyneuropathy. Topiramate and divalproex sodium have utility in the prophylaxis or acute treatment of migraine. Further rigorous studies are needed to clarify the utility of AEDs in nonepileptic conditions.

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Topiramate as add‐on treatment for patients with bipolar mania

Cited by 139 publications

References 24 publications

Effect of Topiramate on Glucocorticoid Receptor Mediated Action

Effect of Topiramate on Glucocorticoid Receptor Mediated Action

Topiramate treatment causes skeletal muscle insulin sensitization and increased Acrp30 secretion in high-fat-fed male Wistar rats

Use of Antiepileptic Drugs for Nonepileptic Conditions: Psychiatric Disorders and Chronic Pain

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