The Weekly Mind Reader: Topiramate's Potential Role in PTSD Treatment

Topiramate is an anticonvulsant medication that works by altering neurotransmitter activity to stabilize abnormal electrical activity in the brain. While primarily prescribed to treat seizures in people with epilepsy and to prevent migraines, a new study published in The Primary Care Companion for CNS Disorders examined off-label use of the drug for improving symptoms associated with post-traumatic stress disorder (PTSD).

Topiramate vs Placebo

The researchers conducted a 12-week study with 72 non-veterans who were diagnosed with PTSD. Half received topiramate, while the other half received a placebo. To measure trauma-related symptoms, the researchers administered the Clinician-Administered PTSD Scale (CAPS), a widely used diagnostic tool that evaluates the frequency and intensity of symptoms related to intrusive thoughts, avoidance behaviors, and hyperarousal, among other factors.  

The group taking topiramate showed a reduction of 39.5 percent in their total PTSD symptoms. Subjects given the placebo saw a 29.5 percent reduction in symptoms. However, the difference between the two groups were not statistically significant. 

The topiramate group also showed some greater improvement in re-experiencing the trauma, avoidance, and hyperarousal. But again, the differences were not statistically significant when compared to placebo.

In terms of safety, the study found that topiramate was generally well-tolerated. The most common side effects reported by both groups were tingling sensations, headaches, fatigue, and difficulty sleeping.

The researchers noted that three times as many patients in the topiramate group saw their PTSD symptoms decrease below the clinical threshold versus to the placebo group. This suggests that the drug does show some promise for treating the condition. Yet again, this difference didn’t reach statistical significance which is why the researchers called for larger studies to confirm the drug’s potential.

The study was notable for using “civilian” subjects versus military veterans. Although veterans are diagnosed with PTSD at a higher rates, it’s a relatively common mental health condition among the general population. According to the National Center for PTSD, about six percent of Americans will experience PTSD at some point in their lives. In veterans, the prevalence is about seven percent. Typical treatments for PTSD include therapies like cognitive behavioral therapy, and medications such as antidepressants.

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