Differential effects of topiramate in patients with traumatic brain injury and obesity--a case series.
BACKGROUND
Topiramate is an antiepileptic drug known to have effects on weight. In order to use this as a tool to treat eating disorders, it is useful to examine whether these effects can be predicted in certain patients.


OBJECTIVE
To report the effects of topiramate, initiated for the treatment of epilepsy, on top of ongoing treatment, on eating patterns and weight of 17 patients with traumatic brain injury (TBI) with post-traumatic epilepsy and weight gain of various etiologies.


METHODS
Patients were followed up according to their usual treatment plan. Topiramate was added on top of current and stable treatment. Dose was titrated based on the patients' neurological status. Patients were asked to report side effects. No other changes were made.


RESULTS
Of the 17 patients included, one patient dropped out. Six patients with binge eating disorder (BED) demonstrated the most pronounced effects, with marked attenuation of binges and normalizing body mass index. Less noticeable were the effects in patients with mood disorders. Topiramate was ineffective in patients whose overweight was a side effect of their medication. Side effects were rated as mild and included somnolence, paresthesias, mild cognitive disturbances and some gastrointestinal disturbances.


CONCLUSIONS
In this report of the actual effects of topiramate in a clinical setting on weight and eating habits of 17 patients with TBI and obesity of various etiologies, topiramate seemed to be a safe intervention. Topiramate appeared to be differentially effective, with particular effects on primary pathological eating patterns.
Dolberg
Ornah T
OT
Department of Psychiatry, Tel Aviv Sourasky Medical Center, Tel Aviv University, Tel Aviv, Israel. orna@lundbeck.com
Barkai
Gaby
G
Gross
Yigal
Y
Schreiber
Shaul
S
D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D001835:Body Weight / Q000187:drug effects; D001930:Brain Injuries / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D002032:Bulimia / Q000188:drug therapy / Q000523:psychology; D004305:Dose-Response Relationship, Drug; D004569:Electroencephalography / Q000187:drug effects; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy; D005247:Feeding Behavior / Q000187:drug effects; D005260:Female; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D009765:Obesity / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications / Q000523:psychology; D000077236:Topiramate
D000927:Anticonvulsants; D018696:Neuroprotective Agents; D000077236:Topiramate; D005632:Fructose