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Topiramate mitigates weight gain in antipsychotic-treated patients with schizophrenia: meta-analysis of randomised

Kah Kheng Goh1, Chun-Hsin Chen1,2, Mong-Liang Lu1,2

  • 1a Department of Psychiatry , Wan-Fang Hospital, Taipei Medical University , Taipei , Taiwan.

International Journal of Psychiatry in Clinical Practice
|March 21, 2018
PubMed
Abstract

Insights

Topiramate effectively reduces weight gain and improves psychopathology in patients with schizophrenia treated with antipsychotics. This meta-analysis confirms its benefits, though further research is recommended.

Area of Science:

  • Psychiatry
  • Pharmacology
  • Metabolic Disorders

Background:

  • Antipsychotic medications for schizophrenia frequently cause significant weight gain.
  • Existing meta-analyses on topiramate for weight reduction in schizophrenia have methodological limitations.

Purpose of the Study:

  • To conduct a rigorous meta-analysis evaluating topiramate's efficacy in mitigating antipsychotic-induced weight gain in schizophrenia patients.
  • To assess topiramate's impact on body weight, BMI, psychopathology, and side effects.

Main Methods:

  • Meta-analysis of ten double-blind, placebo-controlled randomized trials and seven open-label randomized trials.
  • Inclusion of 905 patients with schizophrenia treated with antipsychotics.

Main Results:

  • Topiramate treatment led to significant reductions in body weight and BMI compared to controls.
  • Greater BMI reduction was observed in populations with lower baseline overweight prevalence.
  • Studies from the Middle East and South Asia showed the most substantial weight changes; psychopathology also improved significantly with topiramate.
  • No significant differences in overall side effects were noted between topiramate and control groups.

Conclusions:

  • Topiramate augmentation is a viable strategy for managing antipsychotic-induced weight gain and improving psychopathology in schizophrenia.
  • Further large-scale, methodologically sound studies are warranted to confirm these findings and explore optimal use.
Keywords:
Topiramateantipsychoticsobesityoverweightschizophrenia

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