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Binge Eating Disorder Associated with Obesity Can be Treated with Topiramate

People with binge eating disorders associated with obesity can be treated effectively with the anti-epileptic agent topiramate, say researchers in the United States.

In this 14-week randomised, double-blind, flexible-dose study, investigators at the University of Cincinnati College of Medicine, Ohio, United States, evaluated the topiramate treatment in 53 female and 8 male obese binge eating disorder outpatients.

Of the 61 subjects, body mass index >/=30 kg/m(2), 30 were given topiramate (25-600 mg/day) and 31 placebo. The median dose for topiramate was 212 mg per day, range 50-600.

Binge frequency was the primary efficacy measure and the primary analysis "was a repeated-measures random regression with treatment-by-time as the effect measure."

Topiramate was found to be associated with a significantly greater rate of reduction in binge frequency, binge day frequency, body mass index and weight compared with placebo. It also showed reduced scores on the Yale-Brown Obsessive Compulsive Scale (modified for binge eating) and the Clinical Global Impression severity scale.

Compared with placebo, topiramate showed significantly higher reductions in binge frequency, 46% v 94%, as well as binge day frequency, 46% v 93%.

Topiramate-treated subjects who completed the trial recorded a mean weight loss of 5.9 kg. Because of adverse events, six subjects in the topiramate group and three in placebo did not complete the trial. Three of those given topiramate discontinued due to headache and two because of paresthesias.
Am J Psychiatry 2003 Feb;160:2:255-61. "Topiramate in the treatment of binge eating disorder associated with obesity: a randomized, placebo-controlled trial."

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