Topiramate for binge-eating disorder associated with obesity.
OBJECTIVE
To review the use of topiramate for the treatment of binge-eating disorder (BED) associated with obesity.


METHODS
MEDLINE (1966-July 2006) and the Cochrane Database (2006, issue 3) were used to conduct an English-language literature search. Key search terms included eating disorder, binge-eating, and topiramate. Bibliographies of identified articles were examined for additional references.


RESULTS
BED is characterized by excessive food intake with lack of control during eating episodes, but without subsequent compensatory weight loss mechanisms, and is often associated with obesity and psychiatric disorders. Evidence suggests that topiramate may have mood-stabilizing properties and cause decreased appetite and weight. One case series, 1 case report, 2 open-label studies, and 1 placebo-controlled trial have described the use of topiramate for BED associated with obesity. Doses ranging from 50 to 1400 mg/day were stated to be effective in these reports. Adverse reactions included paresthesias, cognitive impairment, somnolence, and gastrointestinal distress. Although these adverse effects were transient, they may interfere with patients' tolerability of topiramate therapy.


CONCLUSIONS
Albeit limited, evidence suggests that topiramate may be a viable short- and long-term treatment alternative for BED associated with obesity for patients with limited options. Further controlled trials are necessary to establish topiramate's place in therapy, optimal dosing, and length of treatment for this eating disorder.
Tata
Asha L
AL
Virginia Commonwealth University Health System/Medical College of Virginia Hospitals, 401 North 12th St., PO Box 980042, Richmond, VA 23298-0042, USA. atata@mcvh-vcu.edu
Kockler
Denise R
DR
D019440:Anti-Obesity Agents / Q000494:pharmacology / Q000627:therapeutic use; D001835:Body Weight / Q000187:drug effects / Q000502:physiology; D052018:Bulimia Nervosa / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D005632:Fructose / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D009765:Obesity / Q000150:complications / Q000188:drug therapy* / Q000523:psychology; D000077236:Topiramate
D019440:Anti-Obesity Agents; D000077236:Topiramate; D005632:Fructose