TOPIRAMATE - INDUCED WEIGHT LOSS IN SCHIZOPHRENIA: A RETROSPECTIVE CASE SERIES STUDY

Objective Atypical antipsychotics have been associated with weight gain. This study examines the efficacy of adjunctive topiramate in patients with schizophrenia and schizoaffective disorder with antipsychotic-induced weight gain. Methods A 2-year retrospective case analysis was performed in all 300 patients of the outpatient Special Follow-up Clinic for chronic schizophrenia and related psychoses at the Allan Memorial Institute, McGill University Health Centre (Montreal, Canada), a tertiary care University teaching hospital. Results 10 patients met study inclusion criteria. Mean daily topiramate dose was 197.5mg (+/- 77) (range, 125400mg). Topiramate produced continued weight loss throughout the study duration without tolerance. Patients treated for 6 months and more had significantly higher Body Mass Index (BMI) differences than those treated for shorter durations (BMI-d6 (months)=-4.7 +/- 2.4; BMI-d2 (months)=-3.2 +/- 2.3; P= 0.015). BMI changes were similar across genders. Conclusion This study supports topiramate use to target weight loss in stable overweight schizophrenic patients as a potential therapy that requires further investigation.