Predictors of weight loss in adults with topiramate-treated epilepsy.
OBJECTIVE
We examined predictors of weight loss with topiramate, an anticonvulsant associated with weight loss in adults.


METHODS
In this uncontrolled, prospective clinical trial, topiramate was added to existing anticonvulsants in adults (40 to 110 kg) with partial-onset seizures. Primary measurements were change from baseline weight after 3 months and 1 year in patients completing 1 year of topiramate treatment (N = 38). Physiological and metabolic measures were analyzed for correlation with weight loss during topiramate treatment.


RESULTS
In patients who completed 1 year of topiramate treatment, baseline weight was reduced in 82% at 3 months and in 86% at 1 year. Mean body weight was reduced 3.0 kg (3.9% of baseline) at 3 months and 5.9 kg (7.3%) at 1 year. In obese patients [body mass index (BMI) >/= 30 kg/m(2)], mean weight loss was 4.2 kg (4.3%) at 3 months and 10.9 kg (11.0%) at 1 year. Weight loss was primarily caused by reduction in body fat mass. For all patients, weight loss at 3 months correlated most strongly with reduced caloric intake (p = 0.02). At 1 year, caloric intake had returned to baseline levels; weight loss correlated most strongly with higher baseline BMI (p = 0.0007).


CONCLUSIONS
Our results suggest that weight loss occurs in most adults treated with topiramate and is sustained for at least 1 year. Reduced caloric intake may account, in part, for weight loss during early treatment. The pattern of weight loss differs according to baseline BMI, with obese patients experiencing greater weight loss during continued therapy.
Ben-Menachem
Elinor
E
Sahlgrenska Academy at Göteborg University, Göteborg, Sweden. ebm@neuro.gu.se
Axelsen
Mette
M
Johanson
Else Hellebö
EH
Stagge
Anna
A
Smith
Ulf
U
D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D001823:Body Composition / Q000187:drug effects; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood; D002149:Energy Intake; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D005632:Fructose / Q000009:adverse effects* / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005951:Glucose Tolerance Test; D006801:Humans; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000503:physiopathology; D011446:Prospective Studies; D012044:Regression Analysis; D000077236:Topiramate; D015431:Weight Loss / Q000187:drug effects*
D000927:Anticonvulsants; D001786:Blood Glucose; D020738:Leptin; D000077236:Topiramate; D005632:Fructose; D002784:Cholesterol