Weight gain topiramate

Dursun SM, Devarajan S. Clozapine weight gain, plus topiramate weight loss. Can J Psychiatry 2000 45(2) 198. 

Various therapies have been used to avoid or to control weight gain during olanzapine treatment, including nizatidine (SEDA-25, 65), famotidine (SEDA-29,74), and behavioral therapy (SEDA-26, 58). Topiramate has also been used to treat weight gain in 43 women who had taken olanzapine for at least 3 months in a 10-week, doubleblind, placebo-controlled study (283). Those who took topiramate lost on average 5.6 kg (95% Cl— 3.0,8.5). 

Some patients with psychotropic drug-induced weight gain may experience significant weight loss (>7% of body weight) with topiramate up to 200 mg/day for 3 months, but this is not typical, is not often sustained, and has not been systemically studied... 

Canitano R (2005) Clinical experience with Topiramate to counteract neuroleptic induced weight gain in 10 individuals with autistic spectrum disorders. Brain Dev 27 228-232. 

Narula PK, Rehan HS, Unni KE, Gupta N. Topiramate for prevention of olanzapine associated weight gain and metabolic dysfunction in schizophrenia a double-blind, placebo-controlled trial. Schizophr Res 2010 118 218-23. 

In a retrospective chart review, weight loss was assessed in 214 patients with psychiatric disorders taking topiramate (1128). Patients taking either lithium or valproate gained a mean (SD) of 6.3 (9.0) kg and 6.4 (9.0) kg respectively, whereas patients taking topiramate lost 1.2 (6.3) kg. Similar statistically significant results were found in the bone mass index. 

A 28-year-old man with type I bipolar manic disorder was treated with clozapine 550 mg /day he gained 25 kg, and topiramate, a mood stabilizer increasingly used as a weight suppressor, was added (25 mg bd for 1 week increased to 200 mg bd for 5 weeks). His white blood cell count had been 9-10 xl09/l for 2 years while he was taking clozapine, and his complete blood counts were normal for 4 weeks after the addition of topiramate however, but at 5 weeks his white blood cell count was 3.7 xl09/l. 

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