title: A double-blind randomized controlled trial to study the efficacy of topiramate in a civilian sample of PTSD.
abstract: OBJECTIVE
  To evaluate the efficacy and tolerability of topiramate in patients with posttraumatic stress disorder (PTSD).
  
  
  METHODS
  We conducted a 12-week double-blind, randomized, placebo-controlled study comparing topiramate to placebo. Men and women aged 18-62 years with diagnosis of PTSD according to DSM-IV were recruited from the outpatient clinic of the violence program of Federal University of São Paulo Hospital (Prove-UNIFESP), São Paulo City, between April 2006 and December 2009. Subjects were assessed for the Clinician-Administered Posttraumatic Stress Scale (CAPS), Clinical Global Impression, and Beck Depression Inventory (BDI). After 1-week period of washout, 35 patients were randomized to either group. The primary outcome measure was the CAPS total score changes from baseline to the endpoint.
  
  
  RESULTS
  82.35% of patients in the topiramate group exhibited improvements in PTSD symptoms. The efficacy analysis demonstrated that patients in the topiramate group exhibited significant improvements in reexperiencing symptoms: flashbacks, intrusive memories, and nightmares of the trauma (CAPS-B; P= 0.04) and in avoidance/numbing symptoms associated with the trauma, social isolation, and emotional numbing (CAPS-C; P= 0.0001). Furthermore, the experimental group demonstrated a significant difference in decrease in CAPS total score (topiramate -57.78; placebo -32.41; P= 0.0076). Mean topiramate dose was 102.94 mg/d. Topiramate was generally well tolerated.
  
  
  CONCLUSIONS
  Topiramate was effective in improving reexperiencing and avoidance/numbing symptom clusters in patients with PTSD. This study supports the use of anticonvulsants for the improvement of symptoms of PTSD.
authors.affiliation: Department of Psychiatry, Universidade Federal de São Paulo, Brazil.
authors.forename: Mary S L
authors.initials: MS
authors.lastname: Yeh
authors.forename: Jair Jesus
authors.initials: JJ
authors.lastname: Mari
authors.forename: Mariana Caddrobi Pupo
authors.initials: MC
authors.lastname: Costa
authors.forename: Sergio Baxter
authors.initials: SB
authors.lastname: Andreoli
authors.forename: Rodrigo Affonseca
authors.initials: RA
authors.lastname: Bressan
authors.forename: Marcelo Feijó
authors.initials: MF
authors.lastname: Mello
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000379:methods; D004311:Double-Blind Method; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D013313:Stress Disorders, Post-Traumatic / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology*; D000077236:Topiramate; D016896:Treatment Outcome
chemical_list: D018696:Neuroprotective Agents; D000077236:Topiramate; D005632:Fructose