Topiramate as add-on treatment for patients with bipolar mania (original) (raw)

Abstract

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This study investigates the efficacy of topiramate as an adjunct treatment in patients suffering from bipolar mania. A series of clinical evaluations and follow-ups are presented, detailing the weight management and symptomatic improvements observed in patients receiving topiramate. The findings indicate significant reductions in body mass index (BMI) and positive changes in mood stability, suggesting that topiramate may be a viable option for managing bipolar mania alongside other treatments.

Figures (8)

Table 1. Patient characteristics (n = 20)

Table 1. Patient characteristics (n = 20)

Table 2. Pharmacological treatment during the current episode *Three subjects received a combination of lithium and valproate, one subject received carbamazepine and lithium, two subjects receive valproate and carbamazepine, and all subjects receiving gabapentin were also receiving either valproate or carbanazepine. “Clozapine n = 2, risperidone n = 2, olanzapine n= 4, and quetiapine n = 2.

Table 2. Pharmacological treatment during the current episode *Three subjects received a combination of lithium and valproate, one subject received carbamazepine and lithium, two subjects receive valproate and carbamazepine, and all subjects receiving gabapentin were also receiving either valproate or carbanazepine. “Clozapine n = 2, risperidone n = 2, olanzapine n= 4, and quetiapine n = 2.

N/A, not available. *Gabapentin and lamotrigine were administered only in combination treatment, either with valproate or lithium. * Mainly reviewed for previous manic, hypomanic, or mixed episodes and not for depression. Due to nonavailability of more complete « data, it is not possible to conclude on effectiveness for prophylaxis. © Liver function tests.

N/A, not available. *Gabapentin and lamotrigine were administered only in combination treatment, either with valproate or lithium. * Mainly reviewed for previous manic, hypomanic, or mixed episodes and not for depression. Due to nonavailability of more complete « data, it is not possible to conclude on effectiveness for prophylaxis. © Liver function tests.

Table 4. Treatment response *50% or greater reduction in Young Mania Rating Scale and Clinical Global Impression-Bipolar Version Scale of ‘much’ or ‘very much’ improved.

Table 4. Treatment response *50% or greater reduction in Young Mania Rating Scale and Clinical Global Impression-Bipolar Version Scale of ‘much’ or ‘very much’ improved.

“The Wilcoxon signed-ranks test and the ANOVA test showed statistical significance from baseline to either 3 or 5 weeks, results are available upon request. Table 5. Response to topiramate treatment: change in assessment scores*

“The Wilcoxon signed-ranks test and the ANOVA test showed statistical significance from baseline to either 3 or 5 weeks, results are available upon request. Table 5. Response to topiramate treatment: change in assessment scores*

2 In some subjects the duration of follow-up was 10 months. © One subject dropped out at 4 weeks. ° One subject was lost to follow-up at 4 weeks. *o = 0.006 (compared to baseline). *“y = 0.001 (compared to baseline). **1) = 0.002 (compared to baseline). Table 6. Weight and body mass index (BMI) change with topiramate treatment

2 In some subjects the duration of follow-up was 10 months. © One subject dropped out at 4 weeks. ° One subject was lost to follow-up at 4 weeks. *o = 0.006 (compared to baseline). *“y = 0.001 (compared to baseline). **1) = 0.002 (compared to baseline). Table 6. Weight and body mass index (BMI) change with topiramate treatment

®@ BPI, bipolar | disorder; RC, rapid cycling; SA —- bipolar type, schizoaffective disorder — bipolar type.

®@ BPI, bipolar | disorder; RC, rapid cycling; SA —- bipolar type, schizoaffective disorder — bipolar type.

Weight Loss (Mean + SD) in 5 weeks among Subjects Treated with Topiramate Fig. 1. Weight loss (mean + SD) in 5 weeks among subjects treated with topiramate.

Weight Loss (Mean + SD) in 5 weeks among Subjects Treated with Topiramate Fig. 1. Weight loss (mean + SD) in 5 weeks among subjects treated with topiramate.

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