Topiramate attenuates self-injurious behaviour in Prader-Willi Syndrome.
Self-injurious behaviour (SIB), most notably skin picking, has been described by various terms in the literature ranging from neurotic/psychogenic excoriations to compulsive/pathological skin picking. Prader-Willi Syndrome (PWS) is a neurogenetic multisystem disorder characterized by infantile hypotonia, mental retardation, short stature, hypogonadism, dysmorphic features, and hyperphagia with a high risk of obesity. Psychiatric manifestations include SIBs in the form of skin picking, nail biting and rectal gouging. Topiramate is a novel anti-epileptic medication without significant liability of weight gain. There are no published reports of topiramate being utilized in PWS or SIB. We report attenuation of SIB with resultant lesion healing in three PWS adults treated with topiramate in an 8-wk open-label trial. Although our findings should be treated with caution, they suggest that double-blind or cross-over studies with topiramate are warranted to establish the possible role of topiramate in attenuating SIB in PWS and other disorders that involve SIB.
Shapira
Nathan A
NA
Department of Psychiatry, Evelyn F and William L McKnight Brain Institute of the University of Florida, Gainsville 32610-0256, USA. shapira@psych.med.ufl.edu
Lessig
Mary C
MC
Murphy
Tanya K
TK
Driscoll
Daniel J
DJ
Goodman
Wayne K
WK
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D011110:Polymorphism, Genetic / Q000235:genetics; D011218:Prader-Willi Syndrome / Q000175:diagnosis / Q000235:genetics / Q000523:psychology*; D016728:Self-Injurious Behavior / Q000188:drug therapy* / Q000209:etiology; D000077236:Topiramate
D018696:Neuroprotective Agents; D000077236:Topiramate; D005632:Fructose