Topiramate in Bipolar and Schizoaffective Disorders

Abstract

BACKGROUND: Although useful in bipolar disorder, mood stabilizers, such as lithium, divalproex sodium, and carbamazepine, can cause significant weight gain. METHOD: We conducted a retrospective chart review of 5 patients with DSM-IV bipolar disorder or schizoaffective disorder who were treated with topiramate as adjunctive therapy or monotherapy. RESULTS: All 5 patients had a good response to treatment at a mean topiramate dose of 195 mg/day (range, 100-375 mg/day). All patients lost a substantial amount of weight on topiramate treatment. The average weight loss was 22 lb (10 kg; range, 8-56 lb [4-25 kg]). None of the patients discontinued topiramate because of side effects. CONCLUSION: Topiramate may represent a valuable alternative to existing mood stabilizers, either as an adjunct or as monotherapy in patients with bipolar disorder or schizoaffective disorder.

Safety and tolerability of emerging pharmacological treatments for bipolar disorder

“…One randomized, placebo-controlled, double-blind study of topiramate monotherapy involving acutely manic adolescents (n ¼ 56; mean age ¼ 13.8) with bipolar I disorder showed a trend toward drug efficacy by day 28; however, as the study was not carried to completion, firm conclusions cannot be reached (76). Despite limited evidence of efficacy, the tendency of topiramate to reduce weight (44,(71)(72)(73)(74)(75)77) has increased interest in this drug, because overweight and obesity are common in BPD (78,79). Topiramate may also have specific efficacy in bulimia, binge-eating disorder, and alcohol dependence (36).…”

Tratamento do transtorno esquizoafetivo

“…Não foi observado prejuízo com a troca da primeira para a segunda preparação (Centorrino, 2003). Gupta et al (2000) realizaram estudo retrospectivo utilizando registros de 5 pacientes com TAB e transtorno esquizoafetivo tratados com topiramato, sugerindo que esta droga pode ser eficaz como tratamento adjuvante dos portadores destes dois diagnós-ticos, com a vantagem de produzir perda de peso.…”

Weight Gain Mitigation with Topiramate in Mood Disorders

“…One case series by Gupta et al 15 described several patients placed on topiramate as adjunctive therapy to other agents such as lithium, valproate, and various antidepressants. The mean dose of topiramate was 195 mg/day (range 100-375).…”