To review the evidence of weight loss with use of topiramate in patients with mood disorders.
DATA SOURCES
Literature search included MEDLINE (1966—December 2003), International Pharmaceutical Abstracts (1970–December 2003), and EMBASE (1980—December 2003). Search terms included topiramate, weight loss, adverse effect, mood disorders, bipolar disorder.
DATA SYNTHESIS
Weight gain is a common adverse effect of many agents used to treat mood disorders. Topiramate has been evaluated in the management of some mood disorders, and weight loss may be a beneficial side effect in these patients. Case reports, letters to the editor, prospective investigations, and retrospective observational studies were reviewed to identify evidence of weight loss with topiramate use in patients with mood disorders.
CONCLUSIONS
Current evidence suggests an association between topiramate and weight loss. Based on the limited data, controlled studies need to be conducted to define the role of topiramate in patients with mood disorders who would also benefit from weight reduction.
. MalhotraS, McElroySL. Medical management of obesity associated with mental disorders. J Clin Psychiatry2002; 63 (suppl 4): 24–32.
2.
. ElmslieJL, SilverstoneJT, MannJI, WilliamsSM, RomansSE. Prevalence of overweight and obesity in bipolar patients. J Clin Psychiatry2000; 61: 179–84.
3.
. AllisonDB, CaseyDE. Antipsychotic-induced weight gain: a review of the literature. J Clin Psychiatry2001; 62 (suppl 7): 22–31.
4.
. FagioliniA, KupferDJ, HouckPR, NovickDM, FrankE. Obesity as a correlate of outcome in patients with bipolar I disorder. Am J Psychiatry2003; 160: 112–7.
5.
. ColditzGA, WilletWC, RotnitzkyA, MansonJE. Weight gain as a risk factor for clinical diabetes mellitus in women. Ann Intern Med1995; 122: 481–6.
6.
. TeterCJ, EarlyJJ, GibbsCM. Treatment of affective disorder and obesity with topiramate. Ann Pharmacother2000; 34: 1262–4. DOI 10.1345/aph.10027
. LiX, KetterTA, FryeMA. Synaptic, intracellular, and neuroprotective mechanisms of anticonvulsants: are they relevant for the treatment and course of bipolar disorders?J Affect Disorders2002; 69: 1–14.
9.
. YangY, ShuaibA, LiQ, SiddiquiMM. Neuroprotection by delayed administration of topiramate in a rat model of middle cerebral artery embolization. Brain Res1998; 804: 169–76.
10.
. ShapiroNA, GoldsmithTD, McElroySL. Treatment of binge-eating disorder with topiramate: a clinical case series. J Clin Psychiatry2000; 61: 368–72.
11.
. AppolinarioJC, FontenelleLF, PapelbaumM, BuenoJR, CoutinhoW. Topiramate use in obese patients with binge eating disorder: an open study. Can J Psychiatry2002; 47: 271–3.
12.
. RichardD, FerlandJ, LaloneJ, SamsonP, DeshaiesY. Influence of topiramate in the regulation of energy balance. Nutrition2000; 16: 961–6.
13.
. DursanSM, DevarajanS. Accelerated weight loss after treating refractory depression with fluoxetine plus topiramate: possible mechanisms of action?Can J Psychiatry2001; 46: 287–8.
14.
. BrownRO, OrrCD, HannaDL, WilliamsJE, DickersonRN. Topiramate and weight loss in patients with neurodevelopment disabilities. Pharmacotherapy2002; 22: 831–5.
15.
. GuptaS, MasandPS, FrankBL, LockwoodKL, KellerPL. Topiramate in bipolar and schizoaffective disorders: weight loss and efficacy. J Clin Psychiatry2000; 2: 96–100.
16.
. GordonA, PriceLH. Mood stabilization and weight loss with topiramate. Am J Psychiatry1999; 156: 968–9.
17.
. LessigMC, ShapiraNA, MurphyTK. Topiramate for reversing atypical antipsychotic weight gain (letter). J Am Acad Child Adolesc Psychiatry2001; 40: 12.
18.
. ColomF, VietaE, BenabarreA, Martinez-AranA, ReinaresM, CorbellaB, Topiramate abuse in a bipolar patient with an eating disorder. J Clin Psychiatry2001; 16: 167–72.
19.
. McElroySL, SuppesT, KeckPE, FryeMA, DenicoffKD, AltshulerLL, Open-label adjunctive topiramate in the treatment of bipolar disorders. Biol Psychiatry2000; 47: 1025–33.
20.
. BozikasVP, PetrikisP, KourtisA, YoulisP, KaravatosA. Treatment of acute mania with topiramate in hospitalized patients. Prog Neuropsychopharmacol Biol Psychiatry2002; 26: 1203–6.
21.
. Van AmeringenM, ManciniC, PipeB, CampbellM, OakmanJ. Topiramate treatment for SSRI-induced weight gain in anxiety disorders. J Clin Psychiatry2002; 63: 981–4.
22.
. GuilleC, SachsG. Clinical outcome of adjunctive topiramate treatment in a sample of refractory bipolar patients with comorbid conditions. Prog Neuropsychopharmacol Biol Psychiatry2002; 26: 1035–9.
23.
. GhaemiSN, ManwaniSG, KatzowJJ, KoJY, GoodwinFK. Topiramate treatment of bipolar spectrum disorders: a retrospective chart review. Ann Clin Psychiatry2001; 13: 185–9.
24.
. ChengappaKNR, ChalasaniL, BrarJS, ParepallyH, HouckP, LevineJ. Changes in body weight and body mass index among psychiatric patients receiving lithium, valproate, or topiramate: an open-label, nonrandomized, chart review. Clin Ther2002; 24: 1576–84.
25.
. CarpenterL, LeonZ, YasminS, PriceLH. Do obese patients respond to topiramate? A retrospective chart review. J Affect Disord2002; 69: 251–5.
