Weight Loss with Topiramate

Littrell, Kimberly H.; Petty, Richard G.; Hilligoss, Nicole M.; Peabody, Carol D.; Johnson, Craig

doi:10.1345/aph.10414

Cited by 19 publications

(14 citation statements)

References 9 publications

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“…In open‐label studies in patients with bipolar disorder, topiramate treatment has been associated with decreases in weight and BMI (10, 11). Weight loss has also occurred with the use of topiramate in other neurological and psychiatric conditions, including binge‐eating disorder (12, 16, 17, 18, 19).…”

Section: Discussionmentioning

confidence: 99%

Predictors of Weight Loss in Adults with Topiramate‐Treated Epilepsy

et al. 2003

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Research Methods and Procedures:In this uncontrolled, prospective clinical trial, topiramate was added to existing anticonvulsants in adults (40 to 110 kg) with partial-onset seizures. Primary measurements were change from baseline weight after 3 months and 1 year in patients completing 1 year of topiramate treatment (N ϭ 38). Physiological and metabolic measures were analyzed for correlation with weight loss during topiramate treatment. Results:In patients who completed 1 year of topiramate treatment, baseline weight was reduced in 82% at 3 months and in 86% at 1 year. Mean body weight was reduced 3.0 kg (3.9% of baseline) at 3 months and 5.9 kg (7.3%) at 1 year. In obese patients [body mass index (BMI) Ն 30 kg/m 2 ], mean weight loss was 4.2 kg (4.3%) at 3 months and 10.9 kg (11.0%) at 1 year. Weight loss was primarily caused by reduction in body fat mass. For all patients, weight loss at 3 months correlated most strongly with reduced caloric intake (p ϭ 0.02). At 1 year, caloric intake had returned to baseline levels; weight loss correlated most strongly with higher baseline BMI (p ϭ 0.0007). Discussion: Our results suggest that weight loss occurs in most adults treated with topiramate and is sustained for at least 1 year. Reduced caloric intake may account, in part, for weight loss during early treatment. The pattern of weight loss differs according to baseline BMI, with obese patients experiencing greater weight loss during continued therapy.

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Section: Discussionmentioning

confidence: 99%

Predictors of Weight Loss in Adults with Topiramate‐Treated Epilepsy

et al. 2003

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“…Other published reports for divalproex augmentation of olanzapine or risperidone are either open-label [97] or case reports [98]. In a one-year open-label trial [97], valproate (mean dose 1425 mg/day) was added to stable olanzapine treatment (mean dose 19 mg/day) in 10 schizophrenic patients with at least mild hostility, as measured by a score of at least 3 on the PANSS hostility item.…”

Section: Divalproex Augmentationmentioning

confidence: 99%

“…In a one-year open-label trial [97], valproate (mean dose 1425 mg/day) was added to stable olanzapine treatment (mean dose 19 mg/day) in 10 schizophrenic patients with at least mild hostility, as measured by a score of at least 3 on the PANSS hostility item. Hostility scores were significantly reduced from baseline to endpoint.…”

Section: Divalproex Augmentationmentioning

confidence: 99%

A Critical Review of Atypical Antipsychotic Utilization: Comparing Monotherapy with Polypharmacy and Augmentation

Stahl¹,

Mm²

2004

CMC

159

118

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The atypical antipsychotics risperidone, olanzapine, quetiapine, ziprasidone, and aripiprazole have become first-line treatment for schizophrenia because they reduce the positive symptoms of psychosis but do not have a high incidence of extrapyramidal symptoms. However, these agents, like other antipsychotics, may take as long as 16 or more weeks to produce a response, and even with prolonged treatment are unlikely to evoke responses greater than 50% improvement in symptoms. This has led to the experimental use of high atypical antipsychotic doses, antipsychotic polypharmacy, and augmentation with other psychotropic drugs, all of which occur commonly in clinical practice. This article reviews the current evidence for these increasingly common means of treating schizophrenia and psychosis, with particular emphasis on polypharmacy and augmentation. To date, there are only two controlled studies of antipsychotic polypharmacy involving an atypical antipsychotic; the rest of the data are uncontrolled trials and case reports that describe a mixture of positive and negative findings. One multicenter, double-blind trial shows a faster onset of action when divalproex is added to risperidone or olanzapine than with antipsychotic monotherapy. A small double-blind study demonstrates efficacy when lamotrigine is added to clozapine. The rest of the data on augmentation with anticonvulsants are uncontrolled, and most report adverse effects. With the exception of divalproex, there are currently no compelling data to justify the use of antipsychotic polypharmacy or augmentation. Existing evidence suggests that the best treatments for schizophrenia and psychosis may be long-term trials of a sequence of atypical antipsychotic monotherapies at therapeutic doses.

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“…1,2 Documented weight loss associated with topiramate use in patients with seizure or bipolar disorder [3][4][5] has prompted its use in reducing or preventing weight gain associated with antipsychotics. The proposed mechanism of topiramate in promoting weight loss is via improvement in insulin sensitivity related to reduction in leptin concentrations and visceral fat.…”

Section: Introductionmentioning

confidence: 99%

Topiramate: Antipsychotic-Induced Weight Gain

Generali

Cada²

2014

Hosp Pharm

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This Hospital Pharmacy feature is extracted from Off-Label Drug Facts, a publication available from Wolters Kluwer Health. Off-Label Drug Facts is a practitioner-oriented resource for information about specific drug uses that are unapproved by the US Food and Drug Administration. This new guide to the literature enables the health care professional or clinician to quickly identify published studies on off-label uses and determine if a specific use is rational in a patient care scenario. References direct the reader to the full literature for more comprehensive information before patient care decisions are made. Direct questions or comments regarding Off-Label Drug Uses to jgeneral@ku.edu.

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Weight Loss with Topiramate

Cited by 19 publications

References 9 publications

Predictors of Weight Loss in Adults with Topiramate‐Treated Epilepsy

Predictors of Weight Loss in Adults with Topiramate‐Treated Epilepsy

A Critical Review of Atypical Antipsychotic Utilization: Comparing Monotherapy with Polypharmacy and Augmentation

Topiramate: Antipsychotic-Induced Weight Gain

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