Psychopharmacology

, Volume 179, Issue 4, pp 838–845

Differential effects of topiramate in patients with traumatic brain injury and obesity—a case series

  • Ornah T. Dolberg
  • Gaby Barkai
  • Yigal Gross
  • Shaul Schreiber
Original Investigation

DOI: 10.1007/s00213-004-2117-y

Cite this article as:
Dolberg, O.T., Barkai, G., Gross, Y. et al. Psychopharmacology (2005) 179: 838. doi:10.1007/s00213-004-2117-y

Abstract

Rationale

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.

Objectives

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.

Keywords

Binge eating disorderObesityPTSDPost Traumatic Stress DisorderTopiramateTraumatic brain injuryTBIWeight gainEpilepsySide effects

Copyright information

© Springer-Verlag 2004

Authors and Affiliations

  • Ornah T. Dolberg
    • 1
    • 4
  • Gaby Barkai
    • 1
    • 2
  • Yigal Gross
    • 2
    • 3
  • Shaul Schreiber
    • 1
  1. 1.Department of Psychiatry, Tel Aviv Sourasky Medical Center and The Department of Psychiatry, Sackler School of MedicineTel Aviv UniversityTel AvivIsrael
  2. 2.The Neuropsychiatric Unit for Treatment and RehabilitationTel AvivIsrael
  3. 3.Department of PsychologyBar Ilan UniversityGivat ShemuelIsrael
  4. 4.Lundbeck Israel Ltd.Petach TikvaIsrael