Review of the use of Topiramate for treatment of psychiatric disorders

Danilo Arnone, Danilo Arnone

Abstract

BACKGROUND: Topiramate is a new antiepileptic drug, originally designed as an oral hypoglycaemic subsequently approved as anticonvulsant. It has increasingly been used in the treatment of numerous psychiatric conditions and it has also been associated with weight loss potentially relevant in reversing weight gain induced by psychotropic medications. This article reviews pharmacokinetic and pharmacodynamic profile of topiramate, its biological putative role in treating psychiatric disorders and its relevance in clinical practice. METHODS: A comprehensive search from a range of databases was conducted and papers addressing the topic were selected. RESULTS: Thirty-two published reports met criteria for inclusion, 4 controlled and 28 uncontrolled studies. Five unpublished controlled studies were also identified in the treatment of acute mania. CONCLUSIONS: Topiramate lacks efficacy in the treatment of acute mania. Increasing evidence, based on controlled studies, supports the use of topiramate in binge eating disorders, bulimia nervosa, alcohol dependence and possibly in bipolar disorders in depressive phase. In the treatment of rapid cycling bipolar disorders, as adjunctive treatment in refractory bipolar disorder in adults and children, schizophrenia, posttraumatic stress disorder, unipolar depression, emotionally unstable personality disorder and Gilles de la Tourette's syndrome the evidence is entirely based on open label studies, case reports and case series. Regarding weight loss, findings are encouraging and have potential implications in reversing increased body weight, normalisation of glycemic control and blood pressure. Topiramate was generally well tolerated and serious adverse events were rare.

References

    1. Maryanoff BE, Nortey SO, Gardoki JF, Shank RP, Dodgson SP. Anticonvulsant O-alkyl sulpamates. 2, 3 4, 5-bis-O-(1-methylethylidene)-B-D-fructopyranose sulfamate and related compounds. J Med Chem. 1987;30:880–887.
    1. Schneiderman JH. Topiramate: pharmacokinetics and pharmacodynamics. Can J Neurol Sci. 1998;25:S3–5.
    1. Doose DR, Walker SA, Gisclon LG, Nayak RK. Single dose pharmacokinetics and effect of food on the bioavailability of Topiramate, a novel antiepileptic drug. Journal of Clinical Pharmacology. 1996;36:884–891.
    1. Rosenfeld WE. Topiramate: a review of preclinical, pharmacokinetic, and clinical data. Clin Ther. 1997;19:1294–308. doi: 10.1016/S0149-2918(97)80006-9.
    1. Sachdeo RC, Sachdeo SK, Walker SA, Kramer LD, Nayak RK, Doose DR. Steady state pharmacokinetics of Topiramate and carbamazepine in patients with epilepsy during monotherapy and concomitant therapy. Epilepsia. 1996;37:774–780.
    1. Raritan NJ. Topamax package insert. Ortho-McNeil Pharmaceutical. 2000.
    1. Wauquier A, Zhou S. Topiramate: a potent anticonvulsant in the amygdale-kindled rat. Epilepsy Research. 1996;24:73–77. doi: 10.1016/0920-1211(95)00105-0.
    1. Kuzniecky R, Hetherington H, Ho S, Pan J, Martin R, Gilliam F, Hugg J, Faught E. Topiramate increases cerebral GABA in healthy humans. Neurology. 1998;51:627–629.
    1. Gordey M, DeLorey TM, Olsen RW. Differential sensitivity of recombinant GABA (A) receptors expressed in Xenopus oocytes to modulation by Topiramate. Epilepsia. 2000;41:S25–S29.
    1. White HS, Brown SD, Woodhead JH, Skeen GA, Wolf HH. Topiramate modulates GABA – evoked currents in murine cortical neurons by non-benzodiazepine mechanism. Epilepsia. 2000;41:S17–S20.
    1. Gibbs JW, 3rd, Sombati S, DeLorenzo RJ, Coulter DA. Cellular actions of Topiramate: blockade of kainite-evoked inward currents in cultured hippocampal neurons. Epilepsia. 2002;41:S10–S16.
    1. Coulter DA, Sombati S, DeLorenzo RJ. Selective effects of topiramate on sustained and repetitive firing and spontaneous bursting in cultured hippocampal neurons (Abstract) Epilepsia. 1993;34:123.
    1. Dodgson SJ, Shank RP, Marynoff BE. Topiramate as an inhibitor of carbonic anhydrase isoenzymes. Epilepsia. 2000;41:S35–S39.
    1. Takezaki H, Hanaoka M. The use of carbamazapine (Tegretol) in the control of manic-depressive psychoses and other manic, depressive states. Clin Psychiatry. 1971;13:173–182.
    1. Post RM, Uhde TW. Treatment of mood disorders with antiepileptic medications: clinical and theoretical implications. Epilepsia. 1983;24:S97–S108.
    1. Post RM, Frye MA, George MS, Callahan AM. The place of anticonvulsant therapy in bipolar illness. Psychopharmacology. 1996;128:115–129. doi: 10.1007/s002130050117.
    1. Lishman WA. Epilepsy. In: Lishman WA, editor. Organic Psychiatry. London, UK: Blackwell Scientific Publications; 1978. pp. 346–362.
    1. Solomon DA, Miller IW, Ryan CE, Keitner GI. Polypharmacy in Bipolar I Disorder. Psychopharmacol Bull. 1996;32:579–587.
    1. Bowden CL, Calabrese JR, McElroy SL, Gyulai L, Wassef A, Petty F, Pope HG, Jr, Chou JC, Keck PE, Jr, Rhodes LJ, Swann AC, Hirschfeld RM, Wozniak PJ. A randomised placebo-controlled 12 months trial of divalproex and lithium in treatment of outpatients with bipolar I disorder. Divalproex Maintenance Study Group. Arch Gen Psychiatry. 2000;57:481–9. doi: 10.1001/archpsyc.57.5.481.
    1. Chengappa RKN, Gershon S, Levine J. The evolving role of topiramate among other mood stabilizers in the management of bipolar disorder. Bipolar Disorders. 2001;3:215–232.
    1. Thase ME, Sachs GS. Bipolar depression, pharmacotherapy and related therapeutic strategies. Biol Psychiatry. 2000;48:558–572. doi: 10.1016/S0006-3223(00)00980-X.
    1. Dunn RT, Frye MS, Kimbrell TA, Denicoff KD, Leverich GS, Post RM. The efficacy and use of anticonvulsants in mood disorders. Clin Neuropharmacol. 1998;21:215–35.
    1. Calabrese JR, Fatemi SH, Kujawa M, Woyshville MJ. Lithium and the anticonvulsants in the treatment of bipolar disorder. In: Bloom FE, Kupfer DJ, editor. Psychopharmacology: The Fourth Generation of Progress. New York: Raven Press; 1995.
    1. Dubovsky SL, Buzan RD. Novel alternatives and supplements to lithium and anticonvulsants for Bipolar Affective Disorder. J Clin Psychiatry. 1997;58:224–242.
    1. Prien RF, Gelenberg AJ. Alternatives to lithium for preventative treatment of Bipolar Disorder. Am J Psychiatry. 1989;146:840–848.
    1. Maj M, Priozzi R, Kemali D. Long-term outcome of lithium prophylaxis in patients initially classified as complete responders. Neuropsychopharmacology. 1989;98:535–538. doi: 10.1007/BF00441955.
    1. Ghaemi S, Goodwin F. Use of atypical antipsychotic agents in bipolar and schizoaffective disorders: Review of the empirical literature. J Clin Psychopharmacol. 1999;19:354–361. doi: 10.1097/00004714-199908000-00012.
    1. Altshuler LL, Post RM, Leverich GS, Mikalauskas K, Rosoff A, Ackerman L. Antidepressant-induced mania and cycle acceleration: a controversy revisited. Am J Psychiatry. 1995;152:1130–1138.
    1. Stoll AL, Mayer PV, Kolbrener M, Goldstein E, Suplit B, Lucier J, Cohen BM, Tohen M. Antidepressant associated mania: a controlled comparison with spontaneous mania. Am J Psychiatry. 1994;151:1642–1645.
    1. Sporn J, Sachs G. The anticonvulsant lamotrigine in treatment-rasistant manic-depressive illness. J Clin Psychopharmacol. 1997;17:185–189. doi: 10.1097/00004714-199706000-00008.
    1. Calabrese JR, Suppes T, Bowden CL, Sachs GS, Ascher JA, Monaghan E, Rudd GD. A double blind placebo controlled study of lamotrigine monotherapy in outpatients with bipolar I depression. Lamictal 602 Study Group. J Clin Psychiatry. 1999;60:79–88.
    1. Calabrese JR, Suppes T, Bowden CL, Sachs GS, Ascher JA, Monaghan E, Rudd GD. A double blind placebo controlled prophylaxis study of lamotrigine in rapid cycling bipolar disorder. Lamictal 614 Study Group. J Clin Psychiatry. 2000;157:124–126.
    1. Cowen PJ. Treatments for resistant depression. In: Checkley, editor. The management of Depression. London: Blackwell; 1998. pp. 234–251.
    1. Carlsson A, Hansson LO, Carlsson ML. A glutamatergic deficiency model of schizophrenia. Br J Psychiatry. 1999;174:2–6.
    1. Coyle JT. The glutamatergic dysfunction hypothesis of schizophrenia. Harvard Rev Psychiatry. 1996;3:241–53.
    1. Deutsch SI, Rosse RB, Schwartz BL, Mastropaolo J. A revisited excitotoxic hypothesis of schizophrenia: therapeutic implications. Clin Neuropharmacol. 2001;24:43–49. doi: 10.1097/00002826-200101000-00008.
    1. Tamminga CA. Schizophrenia and glutamatergic transmission. Crit Rev Neurobiol. 1998;12:21–36.
    1. Farber NB, Newcomer JW, Olney JW. The glutamate synapse in neuropsychiatric disorders. Prog Brain Res. 1998;116:421–37.
    1. Berlant JL, Van Kammen DP. Open label topiramate as primary or adjunctive therapy in chronic civilian posttraumatic stress disorder: a preliminary report. J Clin Psychiatry. 2002;63:15–20.
    1. Post RM, Weiss SR, Smith M, Li H, McCann U. Kindling versus quenching: implications for the evolution and treatment of posttraumatic stress disorder. Ann NY Acad Sci. 1997;821:285–295.
    1. Clark RD, Canive JM, Calais LA, Qualls CR, Tuason VB. Divalproex in posttraumatic stress disorder: an open label clinical trial. J Trauma Stress. 1999;12:395–401. doi: 10.1023/A:1024797014210.
    1. Ford N. The use of anticonvulsant in posttraumatic stress disorder: case study and overview. J Trauma Stress. 1996;9:857–863.
    1. Keck PE, Jr, McElroy SL, Friedman LM. Valproate and carbamazapine in the treatment of panic and posttraumatic stress disorders, withdrawal states and behavioural dyscontrol syndromes. J Clin Psychopharmacol. 1992;12:36S–41S.
    1. Hertzberg MA, Butterfield MI, Feldman ME, Beckham JC, Sutherland SM, Connor KM, Davidson JR. A preliminary study of lamotrigine for the treatment of posttraumatic stress disorder. Biol Psychiatry. 1999;45:1226–1229. doi: 10.1016/S0006-3223(99)00011-6.
    1. Privitera MD. Topiramate: a new antiepileptic drug. Ann Pharmacother. 1997;31:1164–1173.
    1. Stanley BG, Ha LH, Spears LC, Dee MG., 2nd Lateral hypothalamic injections of glutamate, kainic acid, D, L-alpha-amino-3-hydroxy-5methyl-isoxazole propionic acid or N-methyl-D-aspartic acid rapidly elicit intense transient eating in rats. Brain Res. 1993;613:88–95. doi: 10.1016/0006-8993(93)90458-Y.
    1. Stanley BG, Willett VL, 3rd, Donias HW, Ha LH, Spears LC. The lateral hypothalamus: a primary site mediating excitatory amino acid-elicited eating. Brain Res. 1993;630:41–49. doi: 10.1016/0006-8993(93)90640-9.
    1. de Zwaan M, Mitchell JE, Raymond NC, Spitzer RL. Binge eating disorder: clinical features and treatment of a new diagnosis. Harv Rev Psychiatry. 1994:310–325.
    1. York DA, Singer L, Thomas S, Bray GA. Effect of topiramate on body weight and body composition of Osborne-Mendel rats bed a high fat diet: alteration in hormones, neuropeptides, and uncoupling protein in mRNAs. Nutrition. 2000;16:967–75. doi: 10.1016/S0899-9007(00)00451-2.
    1. Hudson JI, Pope HG. The role of anticonvulsants in the treatment of bulimia. In: McElroy SL, Pope HG, editor. Use of anticonvulsants in Psychiatry: Recent Advances. Clifton, NJ: Oxford Health Care; 1988. pp. 141–154.
    1. Laederach-Hofmann K, Graf C, Horber F, Lippuner K, Lederer S, Michel R, Schneiderr M. Imipramine and diet counseling with psychological support in the treatment of obese binge eaters: a randomized, placebo-controlled double blind study. Int J Eat Disord. 1999;26:231–244. doi: 10.1002/(SICI)1098-108X(199911)26:3<231::AID-EAT1>;2-6.
    1. McCann UD, Agras WS. Successful treatment of non-purging bulimia nervosa with desipramine: a double blind placebo controlled study. Am J Psychiatry. 1990;147:1509–13.
    1. Stunkard A, Berkowitz R, Tanrikut C, Reiss E, Young L. D-Fenfluramine treatment of binge eating disorder. Am J Psychiatry. 1996;153:1455–59.
    1. Fluoxetine Bulimia nervosa study Group Fluoxetine in the treatment of bulimia nervosa: a multi center, placebo controlled, double blind trial. Arch Gen Psychiatry. 1992;49:139–147.
    1. Kaplan AS, Garfinkel PE, Darby PL, Garner DM. Carbamazapine in the treatment of bulimia. Am J Psychiatry. 1983;140:1225–1226.
    1. Wermuth BM, Davis KL, Hollister LE, Stunkard AJ. Phenytoin treatment of binge eating syndrome. Am J Psychiatry. 1977;134:1249–1253.
    1. Green RS, Rau JH. Treatment of compulsive eating disturbances with anti-convulsivant medication. Am J Psychiatry. 1974;131:428–432.
    1. Malcolm R, Myrick H, Brady KT, Ballenger JC. Update on anticonvulsants for the treatment of alcohol withdrawal. Am J Addict. 2001;9:16–23. doi: 10.1080/10550490150504100.
    1. Kohl RR, Katner JS, Chernet E, McBride WJ. Ethanol and negative feedback regulation of mesolimbic dopamine release in rats. Psychopharmacology. 1998;139:79–85. doi: 10.1007/s002130050692.
    1. Dodd PR, Beckmann AM, Davidson MS, Wilce PA. Glutamate-mediated transmission, alcohol, and alcoholism. Neurochem Int. 2000;37:509–533. doi: 10.1016/S0197-0186(00)00061-9.
    1. Breese CR, Freedman R, Leonard SS. Glutamate receptor subtype expression in the human post-mortem brain tissue from schizophrenic and alcohol abusers. Brain Res. 1995;674:82–90. doi: 10.1016/0006-8993(94)01384-T.
    1. Baptista T, Lacruz A, De Mendoza D, Mendoza JM, Silvera R, Angeles F, Mendoza MT, Hernandez L. Body weight gain after administration of antipsychotic drugs. Pharmacopsychiatry. 2002;35:36. doi: 10.1055/s-2002-19839.
    1. Elmslie JL, Silverstone JT, Mann JI, Williams SM, Romans SE. Prevalence of overweight and obesity in bipolar patients. J Clin Psychiatry. 2000;61:179–184.
    1. Allison DB, Mentore JL, Heo M, Chandler LP, Cappelleri JC, Infante MC, Weiden PJ. Antipsychotic-induced weight gain: a comprehensive research synthesis. Am J Psychiatry. 1999;156:1686–1696.
    1. Sachs GS, Guille C. Weight gain associated with use of psychotropic medications. J Clin Psychiatry. 1999;60:16–9.
    1. Willet WC, Diez WH, Colditz GA. Guidelines for healthy weight. N Engl J Med. 1999;341:427–34. doi: 10.1056/NEJM199908053410607.
    1. Cassidy F, Ahearn E, Carroll BJ. Elevated frequency of diabetes mellitus in hospitalized manic depressive patients. Am J Psychiatry. 1999;156:1417–20.
    1. Bray GA, Hollander P, Klein S, Kushner R, Levy B, Fitchet M, Perry BH. A 6-Month Randomized, Placebo-Controlled, Dose-Ranging Trial of Topiramate for Weight Loss in Obesity. Obesity Research. 2003;11:722–733.
    1. Chengappa RKN, Levine J, Rathore D, Parepally H, Atzert R. Long term effects of topiramate on bipolar mood instability, weight change and glycemic control: a case-series. Eur Psychiatry. 2001;16:186–90. doi: 10.1016/S0924-9338(01)00562-4.
    1. Calabrese JR, Keck PE, Jr, McElroy SL, Shelton MD. A pilot study of topiramate as monotherapy in the treatment of acute mania. J Clin Psychopharmacol. 2001;21:340–342. doi: 10.1097/00004714-200106000-00015.
    1. Grunze HC, Normann C, Langosch J, Schaefer M, Amann B, Sterr A, Schloesser S, Kleindienst N, Walden J. Antimanic efficacy of topiramate in 11 patients in an open trial with an on-off design. J Clin Psychiatry. 2001;62:464–8.
    1. Bozikas VP, Petrikis P, Kourtis A, Youlis P, Karavatos A. Treatment of acute mania with topiramate in hospitalized patients. Progress in Neuro-Psychopharmacology & Biological Psychiatry. 2002;26:1203–06. doi: 10.1016/S0278-5846(01)00323-2.
    1. Calabrese JR. A placebo-controlled study of topiramate in acute mania. Munich: European College of Neuropsychopharmacology annual meeting. 2000.
    1. Keck PE, Jr, DelBello MP. Advances in pharmacologic treatment-Bipolar mania. Current Psychiatry. 2002.
    1. Kusumakar V, Lakshmi N, Yatham MB, O'Donovan CA, Kutcher SP. 152nd Annual Meeting of the American Psychiatric Association. Washington, DC; 1999. Topiramate in rapid cycling bipolar women.
    1. Marcotte D. Use of Topiramate, a new anti-epileptic as a mood stabiliser. J Affective Disorder. 1998;50:245–251. doi: 10.1016/S0165-0327(98)00110-4.
    1. Marcotte D. Longer term treatment with topiramate for bipolar disorders. Bipolar Disord. 2001;3:46.
    1. Chengappa RKN, Rathore D, Levine J, Atzert R, Solai L, Parepally H, Levin H, Moffa N, Delaney J, Brar JS. Topiramate as add-on treatment for patients with bipolar mania. Bipolar Disord. 1999;1:42–53. doi: 10.1034/j.1399-5618.1999.10111.x.
    1. McElroy SL, Suppes T, Keck PE, Frye MA, Denicoff KD, Altshuler LL, Brown ES, Nolen WA, Kupka RW, Rochussen J, Leverich GS, Post RM. Open label adjunctive Topiramate in the treatment of bipolar disorders. Biol Psychiatry. 2000;47:1025–33. doi: 10.1016/S0006-3223(99)00316-9.
    1. Sachs G, Koslow GC, Orsini C, Cosgrove V, Sambur M, Demopulos C, Ghaemi S. Topiramate shows efficacy in the treatment of refractory bipolar mood disorder. 22nd Congress of the Collegium of Internationale Psychopharmacologieum. Brussels, Belgium. 2000.
    1. Eads LA, Kramer T. Effects of topiramate on global functioning in treatment-refractory mood disorders: Abstract submitted to the 22nd Congress of the Collegium Internationale Neuro-Psychopharmacolgicum. Brussels, Belgium. 2000.
    1. Ghaemi SN, Manwani SG, Katzow JJ, Ko JY, Goodwin FK. Topiramate treatment of bipolar spectrum disorders: a retrospective chart review. Ann Clin Psychiatry. 2001;13:185–189. doi: 10.1023/A:1014627001201.
    1. Vieta E, Gilabert A, Rodriguez A, Garcia-Castrillon A, Luna MJ, Arrufat F, Garcia Pares G. Efectividad y seguridad del topiramate en el trastorno bipolar resistente. Actas Esp Psiquiatr. 2001;29:148–152.
    1. Saxena S, Fieve R. Adjunctive open label topiramate in bipolar disorder. International Journal of Neuropsychopharmacology. 2002;6:56.
    1. Vieta E, Torrent C, Garcia-Ribas G, Gilabert A, Garcia-Pares G, Rodriguez A, Cadevall J, Garcia-Castrillon J, Lusilla P, Arrufat F. Use of topiramate in treatment-resistant bipolar spectrum disorders. J Clin Psychopharmacol. 2002;22:431–435. doi: 10.1097/00004714-200208000-00017.
    1. Vieta E, Ros S, Valle J, Crespo JM, Valls J, Salgado P. A multicentre study of the efficacy and safety of topiramate in mania. 23rd Congress of the Collegium of Internationale Psychopharmacologieum. Montreal, Canada. 2002.
    1. McInryre RS. An open trial to document the safety and optimal dosing of topiramate as add-on therapy to mood stabilizers in the treatment of subjects with bipolar I or II disorder with unstable mood. American Neuropharmacology Association. 2002.
    1. McIntyre RS, Mancini DA, McCann S, Srinivasan J, Sagman D, Kennedy SH. Topiramate versus Bupropion SR when added to mood stabilizer therapy for the depressive phase of bipolar disorder: a preliminary single blind study. Bipolar Disor. 2002;4:207–213. doi: 10.1034/j.1399-5618.2002.01189.x.
    1. Hussain MZ, Chaudhry ZA, Hussain S. Topiramate in treatment of refractory bipolar depression. Bipolar Disord. 2001;3:43.
    1. DelBello MP, Kowatch RA, Warner J, Schwiers ML, Rappaport KB, Daniels JP, Foster KD, Strakowski SM. Adjunctive topiramate treatment for paediatric bipolar disorder: a retrospective chart review. J Child Adolesc Psychopharmacol. 2002;12:323–330. doi: 10.1089/104454602762599862.
    1. Gordon A, Price HP. Mood stabilization and weight loss with topiramate: Am J Psychiatry. 1999;156:968–969.
    1. Carpenter LL, Leon Z, Yasmin S, Price LH. Do obese depressed patients respond to topiramate? A retrospective chart review. J Affect Disord. 2002;69:251–255. doi: 10.1016/S0165-0327(01)00337-8.
    1. Millson RC, Owen JA, Lorberg GW, Tackaberry L. Topiramate for Refractory Schizophrenia. AJ Psychiatry. 2002;159:67.
    1. Dursun SM, Deakin JFW. Augmenting antipsychotic treatment with lamotrigine or topiramate in patients with treatment resistant schizophrenia: a naturalistic case-series outcome study. J Psychopharmacology. 2001;15:297–301.
    1. Drapalski AL, Rosse RB, Peebles RR, Schwartz BL, Marvel CL, Deutsch SI. Topiramate improves deficit symptoms in a patient with schizophrenia when added to a stable regimen of antipsychotic medication. Clinical Neuropharmacology. 2001;24:290–294. doi: 10.1097/00002826-200109000-00006.
    1. McElroy SL, Arnold LM, Shapira NA, Keck PE, Rosenthal NR, Rezaul Karim M, Kamin M, Hudson JI. Topiramate in the treatment of binge eating disorder associated with obesity: a randomized, placebo-controlled trial. Am J Psychiatry. 2003;160:255–261. doi: 10.1176/appi.ajp.160.2.255.
    1. Hoopes SP, Reimherr FW, Hedges DW, Rosenthal NR, Kamin M, Karim R, Capece JA, Karvois D. Treatment of bulimia nervosa with topiramate in a randomized, double-blind, placebo-controlled trial, part 1: improvement in binge and purge measures. J Clin Psychiatry. 2003;64:1335–41.
    1. Shapira NA, Goldsmith TD, McElroy S. Treatment of binge disorder with topiramate: a clinical case series. J Clin Psychiatry. 2000;61:368–372.
    1. Barbee JG. Topiramate in the treatment of severe bulimia nervosa with co-morbid mood disorders: a case series. International Journal of Eating Disorders. 2003;33:468–472. doi: 10.1002/eat.10154.
    1. Berlant JL, Van Kammen DP. Open label topiramate as primary or adjunctive therapy in chronic civilian posttraumatic stress disorder: a preliminary report. J Clin Psychiatry. 2002;63:15–20.
    1. Johnson BA, Ait-Daoud , Bowden CL, DiClemente C, Roache JD, Lawson K, Javors MA, MA JZ. Oral Topiramate in the treatment of alcohol dependence: a randomised controlled trial. Lancet. 2003;361:1677–85. doi: 10.1016/S0140-6736(03)13370-3.
    1. Abuzzahab FS, Brown VL. Control of Tourette's syndrome with Topiramate. A J Psychiatry. 2001;158:968. doi: 10.1176/appi.ajp.158.6.968.
    1. Cassano P, Lattanzi L, Pini S, Dell'Osso L, Battistini G, Cassano GB. Topiramate for self mutilation in a patient with borderline personality disorder. Bipolar Disorders. 2001;3:161. doi: 10.1034/j.1399-5618.2001.030306.x.
    1. Teter CJ, Early JJ, Gibbs CM. Treatment of affective disorder and obesity with topiramate. Ann Pharmacother. 2000;34:1262–5. doi: 10.1345/aph.10027.
    1. Privitera M, Fincham R, Penry J, Reife R, Kramer L, Pledger G, Karim R. Topiramate placebo controlled dose-ranging trial in refractory partial epilepsy using 600-, 800-, and 1000- mg daily dosages. Neurology. 1996;46:1678–83.
    1. Marson AG, Kadir ZA, Chadwick DW. New antiepileptic drugs: a systematic review of their efficacy and tolerability. BMJ. 1996;313:1169–1174.
    1. Tassinari CA, Mechelucci R, Chauvel P, Chodiewicz J, Shorvon S, Henricksen O, Dam M, Reife R, Pledger G, Karim R. Double blind placebo controlled trial of topiramate (600 mg daily) for the treatment of refractory partial epilepsy. Epilepsia. 1996;37:763–768.
    1. Ben Menachem E, Henriksen O, Dam M, Schmidt D. Double blind, placebo- controlled trial of topiramate as add-on therapy in patients with refractory partial seizures. Epilepsia. 1996;37:539–543.
    1. Shorvon SD. Safety of topiramate: adverse effects and relationships to dosing. Epilepsia. 1996;37:S18–22.
    1. Visscher TL, Seidell JC. The public health impact of obesity. Ann Rev Public Health. 2001;22:355–75. doi: 10.1146/annurev.publhealth.22.1.355.
    1. Terence AK. Low dose adjunctive topiramate attenuates weight gain in bipolar disorder patients. The international Journal of Neuropsychopharmacology. 2000;3:S344.
    1. Garonna F, Stifani L. Topiramate in the treatment of overweight/obese binge eaters. International Journal of Neuropsychopharmacology. 2000;3:S299.

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