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Topiramate in Bipolar and Schizoaffective Disorders: Weight Loss and Efficacy
Sanjay Gupta1, Prakash S. Masand, Bradford L. Frank
1Department of Psychiatry, Olean General Hospital, Olean; the Department of Psychiatry, SUNY Upstate Medical University at Syracuse, Syracuse; the Department of Psychiatry, University of Buffalo, Buffalo; the Department of Psychiatry, WCA Hospital, Jamestown; the Research and Education Division, Psychiatric Network, Olean; and Cattaraugus County Continuing Day Treatment Program, Olean, N.Y.
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.
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