Topiramate in Bipolar and Schizoaffective Disorders: Weight Loss and Efficacy

Background: Although useful in bipolar disorder, mood stabilizers, such as lithium, divalproex sodium, and carbamazepine, can cause significant weight gain.

Method: We conducted a retrospective chart review of 5 patients with DSM-IV bipolar disorder or schizoaffective disorder who were treated with topiramate as adjunctive therapy or monotherapy.

Results: All 5 patients had a good response to treatment at a mean topiramate dose of 195 mg/day (range, 100-375 mg/day). All patients lost a substantial amount of weight on topiramate treatment. The average weight loss was 22 lb (10 kg; range, 8-56 lb [4-25 kg]). None of the patients discontinued topiramate because of side effects.

Conclusion: Topiramate may represent a valuable alternative to existing mood stabilizers, either as an adjunct or as monotherapy in patients with bipolar disorder or schizoaffective disorder.