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Topiramate appears to safe and effective in influencing the frequency of binging/purging, body weight, and HRQOL in bulimic patients.

The aim of this study was to compare the efficacy of topiramate versus a placebo in the treatment of adiposity in women undergoing olanzapine therapy. We also assessed changes health-related quality of life, the patient's actual state of health, and psychologic impairments. The 10-week, random, double-blind, placebo-controlled study included 43 women who had been treated with olanzapine (mean dose 7.8 +/- 3.6 in the topiramate group and 7.2 +/- 3.1 in the placebo group) and had gained weight as a side effect. The subjects were randomly assigned to topiramate (n = 25) or a placebo (n = 18). Primary outcome measures were weight checks and self-reported changes on the scales of the SF-36 Health Survey, Bf-S Scale of Well-Being, and the Adjective Checklist EWL-60-S. Weight loss was observed and was significantly more pronounced in the topiramate-treated group (difference in weight loss between the 2 groups: 5.6 kg, 95% CI = -8.5, -3.0, P < 0.001). In comparison with the placebo group, significant changes on 7 (7/8) scales of SF-36 Health Survey (all P < 0.001), on all 6 scales of the EWL-60-S, and on the Bf-S were observed in the topiramate-treated subjects after 10 weeks. All patients tolerated topiramate well. Topiramate appears to be a safe and effective agent in the treatment of weight gain that occurred during olanzapine treatment. Significantly positive changes in health-related quality of life, the patient's actual state of health, and psychologic impairments were observed.

SUMMARY Rates and mechanisms of myoglobin removal from plasma were examined in closed-chest dogs, using disappearance patterns of immunoreactivity and radioactivity after i.v. canine myoglobin radiolabeled with '"I. Arterial immunoreactive myoglobin concentration decreased monoexponentially over a 2-decade range, with rate constants of disappearance averaging 0.080 i 0.014 min-' (i SD) (corresponding to half-times of disappearance of 8.9 ± 1.5 mmn). Renal SERUM MYOGLOBIN concentration is elevated abnormally in the early phase of myocardial infarction in almost all patients seen within 12-14 hours of the onset of chest pain.14 Elevations in myoglobin frequently precede elevations of creatine kinase (CK); Stone et al.5 reported that 45% of infarct patients show increased myoglobin levels with normal CK levels at the time of admission. Elevated myoglobin levels peak earlier and return toward normal more rapidly than elevated CK levels. Myoglobin concentration-time curves sometimes show multiple peaks during the first several hours of apparently uncomplicated infarction.9Although the basis for these differing patterns of myoglobin and CK elevation has not been defined, a difference in a rate of removal from serum is an important possibility. CK disappearance from the intravascular space has been characterized.10 Although similar information for myoglobin is not available, myoglobin disappearance rates may be faster than those for CK; the kidney may play an important role."1'-4 If it does, sequential measurements of serum myoglobin may be useful for defining patterns of protein entry into the intravascular space during ischemic syndromes. Patients in the early states of myocardial injury -who may be the ideal candidates for interventions intended to minimize myocardial injury -might be identified as those with a normal serum myoglobin level on admission or a rapidly rising serum myoglobin over an interval of a few hours.The present study was designed to define rates and mechanisms of clearance from the circulation of a bolus of radiolabeled myoglobin administered intravenously. The studies capitalized on the sensitivity of recently developed radioimmunoassay techniques for quantifying plasma myoglobin concentration. The immunoassay also offered the opportunity to contrast changing patterns of plasma immunoreactivity and radioactivity, the former presumably reflecting disposition of the native molecule and the latter catabolic byproducts circulating within the vascular space as well as the native molecule. MethodsCanine myoglobin for exogenous administration and preparation of anti-dog myoglobin antibody was purified in a fashion similar to that for human myoglobin.6 Sequential steps included homogenization of canine myocardium in buffered saline, centrifugation and isolation of the supernatant, precipitation of protein with 50% ammonium sulfate, repeat centrifugation with dialysis of the supernatant against saturated ammonium sulfate, dissolution of the precipitate with subsequent dialysis against 0.02 M phosphate ...

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