A Clinical Trial of Topiramate for Weight Loss in Schizophrenia with Overweight or Obesity

Ko, Young Hoon; Joe, Sook Haeng; Do, Seok Young; Cho, Woong; Park, Jeong Hyun; Chun, Dong Yeol; Kim, Ki Tae; Woo, Geum Seok; Kwon, Sung Min

Abstract

OBJECTIVE
Antipsychotic-induced weight gain is associated with treatment noncompliance and is also known to be associated with several medical conditions in schizophrenia. Topiramate, a relatively new antiepileptic drug, is currently used for mood and eating disorders, and also offers the advantage of weight loss. This study explored the efficacy and tolerability of topiramate as an adjuvant treatment of schizophrenia with overweight or obesity. METHODS: In this 8-week, prospective open trial, 30 hospitalized, schizophrenic patients took topiramate at a mean maintenance dosage of 159.37+/-61.15 mg/day. The primary measures were weight, body mass index (BMI), waist circumference, hip circumference, and waist-to-hip ratio. The safety measures included adverse events, physical examination, clinical laboratory data, and vital signs. The Clinical Global Impression Severity (CGI-S) Scale was used to quantify changes in schizophrenic symptoms and signs. RESULTS: Body weight, BMI, waist circumference, and hip circumference decreased significantly after treatment but the waist-to-hip ratio did not. The changes of body weight and BMI during 8 weeks treatment with topiramate were significantly correlated with the maintenance dose of topiramate. The high dose group (>100 mg/d) was significantly more changed in body weight and BMI between baseline and 8 weeks than the low dose group (< or =100 mg/d). The scores on the CGI-S scale decreased significantly over the 8 weeks of treatment. CONCLUSION: The results suggest that topiramate is both efficacious and tolerable for the short-term adjuvant treatment of schizophrenia with overweight or obesity. Further placebo controlled studies included larger samples would be needed to confirm these results. And much more clinical researches should be required to establish guideline for the optimal dose and duration of treatment using topiramate as an antiobesity agent in schizophrenia.