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Topiramate use in obese patients with binge eating disorder: an open study
Jose C Appolinario1, Leonardo F Fontenelle, Marcelo Papelbaum
1Obesity and Eating Disorders Group, Institute of Psychiatry, Federal University of Rio de Janeiro (IPUB/UFRJ), State Institute of Diabetes and Endocrinology of Rio de Janeiro (IEDE), Rio de Janeiro, Brazil. appolinario@biohard.com.br
Objective:
To assess topiramate's efficacy and tolerability in a group of obese binge eaters with no neuropsychiatric comorbidity.
Method:
We consecutively selected 8 obese patients with binge eating disorder (BED) and no medical or psychiatric comorbidity from individuals seeking treatment for obesity. Treatment with topiramate at 150 mg daily was administered over a 16-week period. To assess outcome, we employed the days with binge episodes per week (DBE), the Binge Eating Scale (BES), the Beck Depression Inventory (BDI), and body weight evaluation.
Results:
Of the 6 patients who completed the trial, all showed reduced binge eating. Four patients presented a total remission, and 2 had a marked reduction in binge eating frequency. The mean DBE decreased significantly from 4.3 to 1.1 (P = 0.03), as did the BES scores, which fell from 31.8 to 15.3 (P = 0.04). Moreover, there was a statistically significant weight loss (mean 4.1 kg, P = 0.04). The most frequent side effects were paresthesias, fatigue, and somnolence.
Conclusion:
Topiramate may be an effective and well-tolerated agent in the treatment of BED in obese patients.