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Topiramate-induced weight loss in schizophrenia: a retrospective case series study
Emmanuel Lévy1, Catherine Agbokou, Florian Ferreri
1Clinical Psychopharmacology Unit, McGill University Health Centre and Department of Psychiatry, McGill University, Montreal, Quebec, Canada. psychopharm.unit@staff.mcgill.ca
Objective:
Atypical antipsychotics have been associated with weight gain. This study examines the efficacy of adjunctive topiramate in patients with schizophrenia and schizoaffective disorder with antipsychotic-induced weight gain.
Methods:
A 2-year retrospective case analysis was performed in all 300 patients of the outpatient Special Follow-up Clinic for chronic schizophrenia and related psychoses at the Allan Memorial Institute, McGill University Health Centre (Montreal, Canada), a tertiary care University teaching hospital.
Results:
10 patients met study inclusion criteria. Mean daily topiramate dose was 197.5 mg (A+/-77) (range, 125-400 mg). Topiramate produced continued weight loss throughout the study duration without tolerance. Patients treated for 6 months and more had significantly higher Body Mass Index (BMI) differences than those treated for shorter durations (BMI-d6 months=-4.7A+/-2.4; BMI-d2 months=-3.2A+/-2.3; P=0.015). BMI changes were similar across genders.
Conclusion:
This study supports topiramate use to target weight loss in stable overweight schizophrenic patients as a potential therapy that requires further investigation.
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