title: Do obese depressed patients respond to topiramate? A retrospective chart review.
abstract: BACKGROUND
  Topiramate, a novel anticonvulsant, has shown promise in preliminary open trials in bipolar disorder, but there are no studies in primary depression. Topiramate's tendency to cause weight loss could be advantageous for many patients with mood disorders.
  
  
  METHODS
  A chart review was conducted on 16 female outpatients with a primary major depressive episode and mild to moderate obesity who received open-label adjunctive topiramate. Ongoing psychotropics were continued at previous doses. Self-report symptoms were assessed before and after acute phase (4-8 weeks) treatment in a subset of 11 patients, and clinician ratings were assessed at all visits during extended phase (up to 40 weeks) treatment for the entire group.
  
  
  RESULTS
  Patient and clinician symptom ratings dropped significantly during acute phase treatment (5.5+/-1.2 weeks), but only 36% of patients were judged responders. At extended phase endpoint (17.7+/-13.4 weeks), 44% of patients were responders. Body mass index decreased significantly on topiramate, reflecting a mean weight loss of 6.1+/-8.2% from baseline. Central nervous system side effects were prominent.
  
  
  CONCLUSIONS
  Topiramate may have potential for the adjunctive treatment of depression in obese patients, but close monitoring of weight and adverse effects is warranted.
authors.affiliation: Mood Disorders Program, Butler Hospital and Department of Psychiatry and Human Behavior, Brown University School of Medicine, 345 Blackstone Blvd., Providence, RI 02906, USA. linda_carpenter_md@brown.edu
authors.forename: Linda L
authors.initials: LL
authors.lastname: Carpenter
authors.forename: Zelko
authors.initials: Z
authors.lastname: Leon
authors.forename: Sarah
authors.initials: S
authors.lastname: Yasmin
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Price
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001835:Body Weight / Q000187:drug effects; D003865:Major Depressive Disorder / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D006801:Humans; D009765:Obesity / Q000150:complications*; D012189:Retrospective Studies; D000077236:Topiramate
chemical_list: D000928:Antidepressive Agents; D000077236:Topiramate; D005632:Fructose