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Adjunctive zonisamide for weight loss in euthymic bipolar disorder patients: a pilot study
Po W Wang1, Yen-shou Yang, Rebecca A Chandler
1Stanford University School of Medicine, 401 Quarry Road, Suite 2117, Stanford, CA 94305-5723, United States. wangp0@stanford.edu
Journal of Psychiatric Research
|July 14, 2007
Summary
Adjunctive zonisamide showed effectiveness in treating obesity for bipolar disorder (BD) patients, leading to significant weight loss. However, it also presented a high incidence of adverse mood events, necessitating further controlled trials.
Area of Science:
- Psychiatry
- Pharmacology
- Obesity Research
Background:
- Obesity is a common comorbidity in patients with bipolar disorder (BD).
- Effective and safe weight management strategies are needed for BD patients, who often experience medication-induced weight gain.
- Zonisamide is an anticonvulsant with potential weight-reducing properties.
Purpose of the Study:
- To evaluate the efficacy and tolerability of open-label adjunctive zonisamide for obesity treatment in euthymic bipolar disorder patients.
- To assess weight changes and adverse events associated with zonisamide use in this population.
Main Methods:
- A prospective, open-label study involving overweight, euthymic bipolar disorder outpatients.
- Zonisamide was administered for up to six months, with regular assessments of Body Mass Index (BMI) and mood symptoms.
- Weight loss was analyzed using random effects modeling.
Main Results:
- Twenty-five BD patients received zonisamide, resulting in a mean weight loss of 1.2 BMI points (p<0.003).
- The mean duration of treatment was approximately 14 weeks, with a mean final dose of 375 mg/day.
- A significant proportion of patients (72%) discontinued early, primarily due to emergent mood symptoms (44%) or adverse physical events (20%).
Conclusions:
- Adjunctive zonisamide demonstrated effectiveness in reducing weight among obese bipolar disorder patients.
- While generally physically tolerated, zonisamide was associated with a high rate of mood-related adverse events.
- Controlled trials are recommended to further investigate these findings and the risk-benefit profile of zonisamide in BD patients.
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