Topiramate: Efficacy for Obese Patients with BED

Reprinted from Eating Disorders Review
March/April 2003 Volume 14, Number 2
©2003 Gürze Books

When it was learned that a common side effect of the antiepileptic agent topiramate was weight loss, the drug quickly became of interest to eating disorders researchers. Some studies have suggested that this drug might be especially useful for obese patients with binge eating disorder (BED). In one recent controlled study, this drug was effective and relatively well tolerated by patients with BED (Am J Psychiatry 2003;160:255).

Dr. Susan L. McElroy and colleagues at the University of Cincinnati College of Medicine tested topiramate in 61 outpatients with BED who had a mean body mass index (BMI) of at least 30 (kg/m2). One group (30 patients) received topiramate and the second (31 patients) received a placebo.

The group who received topiramate had a significantly greater reduction in frequency of binge eating, binge day frequency, BMI, body weight, and scores on the Clinical Global Impression severity scale and the Yale-Brown Obsessive-Compulsive scale, which was modified for binge eating. In the topiramate group, binge frequency was reduced by 94%, compared to 46% in the placebo group. The mean weight loss for subjects treated with topiramate was 5.9 kg, or 12.9 lb. The median dose for topiramate was 212 mg/day, and dosages ranged from 50 kg to 600 kg.

Adverse effects

Nine patients, including 3 in the placebo group and 6 in the topiramate group, withdrew from the study because of adverse effects. (One common side effect is confusion [“word finding”], which is why the drug has been nicknamed “Dopamax.”) In this study, the most common reasons for discontinuing the drug were headache (3 persons) and paresthesias (2 persons).

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