Topiramate medication drug
Topiramate is a
pharmaceutical drug
used with other medications to treat certain types of
seizures in patients with
epilepsy or Lennox-Gastaut syndrome (a disorder that causes seizures and
developmental delays). Topiramate is used to treat patients who continue to have
seizures even when they take other anti-seizure medications.
Topiramate is also used in
migraine prophylaxis. Topiramate tablets and
topiramate Sprinkle Capsules are indicated for adults for the prophylaxis of
migraine headache. The usefulness of topiramate in the acute treatment of migraine
headache has not been studied.
Topiramate has been tested for weight loss.
Topiramate is contraindicated in patients with a history of hypersensitivity to any
component of this product.
Topiramate side effects
The most common topiramate side effects are paresthesias, anorexia, fatigue,
nausea, diarrhea, weight
decrease, and taste alteration. Those prescribed topiramate should be instructed
to drink lots of fluids to reduce the risk of kidney stone formation. Topiramate has been associated with serious side effects, including:
Hyperchloremic, non-anion gap metabolic acidosis - lowering of bicarbonate
levels in the blood. Measurement of baseline and periodic serum bicarbonate is
recommended.
Acute myopia and secondary angle-closure glaucoma.
Oligohidrosis and hyperthermia - decreased sweating and increased body
temperature, especially in hot weather. this is more likely to happen in
children.
Cognitive/psychiatric side effects including cognitive dysfunction,
psychiatric/behavioral disturbances including suicidal thoughts or behavior, and
somnolence and fatigue.
Topiramate and weight loss
The effect of topiramate on energy balance in obese
men: a 6-month double-blind randomized placebo-controlled study with a 6-month
open-label extension.
Eur J Clin Pharmacol. 2007 Jan 3; Division of Kinesiology (PEPS), Department
of Social and Preventive Medicine, Laval University, G1K 7P4, Quebec, Canada
Topiramate has been reported to reduce body weight beyond a placebo in the
treatment of obese participants, but the effect of this agent on components of
energy balance has not yet been established in humans. Thus, the aim of this
study was to study the impact of Topiramate on food preferences, measures of
satiety, food intake, resting metabolic rate, and 24-h energy expenditure.
The study design consisted of a 6-month, single-center, randomized,
double-blind, parallel group, placebo-controlled trial with a 6-month open-label
extension. The study included 68 sedentary men with abdominal obesity (waist
circumference >/=100 cm), of between 25 and 55 years of age, with a dyslipidemic
profile and a body mass index (BMI) >/=27 and </=40 kg/m(2). Treatment with
Topiramate produced significant changes in anthropometric variables and body
composition compared with placebo. CONCLUSION: Topiramate treatment produced
significantly greater weight loss than placebo and the majority of this loss was
explained by a decrease in body fat stores. Most of the weight loss effect
produced by Topiramate therapy was observed within a period of 6 months.
Finally, Topiramate treatment had an impact on energy balance through a
reduction in food intake that appears to have created an energy deficit of about
30,000-40,000 kcal compared with treatment with the placebo over 6 months.
Topiramate and sleep
Efficacy and tolerability of open-label topiramate in the treatment of
sleep-related eating disorder: a retrospective case series.
J Clin Psychiatry. 2006 Nov;67(11):1729-34. Winkelman JW. Division of Sleep
Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
02115, USA.
Determine the efficacy and tolerability of topiramate in the treatment of
sleep-related eating disorder (SRED). This is a retrospective chart review of
consecutive patients treated in an open-label trial of topiramate for SRED in a
sleep disorders clinic. Patients were diagnosed according to the second edition
of the International Classification of Sleep Disorders. Patients with a Clinical
Global Impressions of Improvement (CGI-I) rating of "very much" or "much"
improved were considered treatment responders. 30 subjects were prescribed
topiramate, of whom 25 had at least 1 postbaseline follow-up appointment.
CONCLUSION: In this open-label retrospective trial, topiramate was found to be
very effective in reducing nocturnal eating in patients with chronic SRED. The
tolerability of topiramate was an issue in some patients. Given the promise of
this approach, but the limitations of this study, prospective, double-blind
study of topiramate in a larger sample of patients with SRED is warranted.