Topiramate in the Treatment of Comorbid Night Eating Syndrome and PTSD: A Case Study

Tucker, Phebe; Masters, Barbara; Nawar, Ola

doi:10.1080/10640260490267779

Cited by 19 publications

(10 citation statements)

References 11 publications

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“…The heterogeneous clinical symptoms parallel broad biological dysfunction in the hypothalamic-pituitary axis (HPA) (2)(3)(4)(5)(6)(7)(8)(9)(10) and autonomic (ANS) (4,(11)(12)(13) and central nervous system (CNS) functions (14)(15)(16)(17). Previous studies have provided evidence for a low level pro-inflammatory state in PTSD (18)(19)(20)(21)(22). The CNS areas involved are central regulators of the HPA axis and the ANS, and this coordinated dysfunction in PTSD is compatible with inflammatory disinhibition.…”

Section: Introductionmentioning

confidence: 79%

Gene expression analysis in combat veterans with and without post-traumatic stress disorder

Hollifield

Moore

Yount

2013

Molecular Medicine Reports

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Post-traumatic stress disorder (PTSD) is a common, debilitating and complex disorder. Numerous genetic and environmental factors are important in the genesis and maintenance of PTSD. Thus, gene expression analysis (GEA) is a critical technology for PTSD research since it detects essential genetic output affected by gene-environment interactions. Quality control methods are rarely reported in gene expression studies. The present study aimed to identify reliably expressed genes in whole blood samples from subjects with combat-induced PTSD (n=6) and, secondly, to investigate the expression of genes that may be differentially expressed in PTSD compared with an appropriate control group (n=11). Strict quality control methods were used. From a theoretically driven set of 42 genes, 17 were reliably detected using quantitative PCR on samples from 17 combat-exposed veterans. Four of these 17 genes were consistently and modestly correlated with clinical phenotypes and had significant expression effects on phenotypes. These genes regulate inflammatory systems and are regulated by the adrenergic system, consistent with peripheral markers important in PTSD. Inflammatory disinhibition may be involved in combat-induced PTSD, and may be responsible for the increased prevalence of inflammatory‑related illnesses observed in PTSD. This is a preliminary study with a small sample size. A number of genes are not reliably detected by the current methodology. Improved detection methods are important to extend the current study and to further understand mechanisms in PTSD.

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Section: Introductionmentioning

confidence: 79%

Gene expression analysis in combat veterans with and without post-traumatic stress disorder

Hollifield

Moore

Yount

2013

Molecular Medicine Reports

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“…Three case reports have shown the beneficial effects of topiramate, a GABA agonist and glutamatergic antagonist, in treatment of NES. 30 , 85 , 97 In these case reports, it was shown that adding topiramate treatment to ongoing treatments improved NES symptoms and led to significant weight loss. However, after dose reduction or treatment discontinuation, NES symptoms had returned in these patients.…”

Section: Pharmaceutical Treatment Of Nesmentioning

confidence: 94%

Optimal management of night eating syndrome: challenges and solutions

Küçükgöncü¹,

Midura²,

Tek³

2015

NDT

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Night Eating Syndrome (NES) is a unique disorder characterized by a delayed pattern of food intake in which recurrent episodes of nocturnal eating and/or excessive food consumption occur after the evening meal. NES is a clinically important disorder due to its relationship to obesity, its association with other psychiatric disorders, and problems concerning sleep. However, NES often goes unrecognized by both health professionals and patients. The lack of knowledge regarding NES in clinical settings may lead to inadequate diagnoses and inappropriate treatment approaches. Therefore, the proper diagnosis of NES is the most important issue when identifying NES and providing treatment for this disorder. Clinical assessment tools such as the Night Eating Questionnaire may help health professionals working with populations vulnerable to NES. Although NES treatment studies are still in their infancy, antidepressant treatments and psychological therapies can be used for optimal management of patients with NES. Other treatment options such as melatonergic medications, light therapy, and the anticonvulsant topiramate also hold promise as future treatment options. The purpose of this review is to provide a summary of NES, including its diagnosis, comorbidities, and treatment approaches. Possible challenges addressing patients with NES and management options are also discussed.

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“…Winkelman (2003) observed a reduction in nocturnal awakenings with food intake, improved sleep and weight loss in two patients who failed prior treatments with psychotherapy and pharmacotherapy. 35 Tucker et al (2004) reported the case of a 40-year-old obese woman treated with topiramate for 8 months, who achieved reduction in episodes of nocturnal awakenings accompanied by food intake. 36 Cooper-Kazaz (2012) reported the case of a non-obese female patient under treatment for depression with venlafaxine, who developed NES and weight gain.…”

Section: Pharmacological Treatmentmentioning

confidence: 99%

“…35 Tucker et al (2004) reported the case of a 40-year-old obese woman treated with topiramate for 8 months, who achieved reduction in episodes of nocturnal awakenings accompanied by food intake. 36 Cooper-Kazaz (2012) reported the case of a non-obese female patient under treatment for depression with venlafaxine, who developed NES and weight gain. She received topiramate for 6 weeks, with improvement of night eating symptoms, sleep quality, self-esteem and well-being, and weight loss.…”

Section: Pharmacological Treatmentmentioning

confidence: 99%

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Night eating syndrome: How to treat it?

Pinto

Silva²,

Bruin³

et al. 2016

Rev. Assoc. Med. Bras.

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Night eating syndrome (NES) is characterized by caloric intake ≥ 25% of total daily after dinner and/or by two or more weekly nocturnal awakenings accompanied by food ingestion. Causes of NES are not entirely clear and seem to involve a desynchronization between the circadian rhythms of food ingestion and sleep, resulting in a delayed pattern of food intake. Estimates of the prevalence of NES in the general population are around 1.5%, and although much higher frequencies have been described in obese individuals, a causal relationship between NES and obesity is not clearly established. Since the first NES reports, several treatment modalities have been proposed, although, in many cases, the evidence is still insufficient and there is no consensus on the ideal approach. In order to conduct a critical review of proposed treatments for NES since its original description, a systematic search of articles published in journals indexed in Medline/ Pubmed database in the period 1955-2015 was performed. Seventeen articles addressing non-pharmacological and pharmacological therapies met the selection criteria. Based on the articles analyzed, we conclude that serotonergic agents and psychological interventions, particularly cognitive behavioral therapy, have been shown to be effective for the treatment of NES. A combination of non--pharmacological and pharmacological therapies must be considered in future studies on the treatment of these patients.

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Topiramate in the Treatment of Comorbid Night Eating Syndrome and PTSD: A Case Study

Cited by 19 publications

References 11 publications

Gene expression analysis in combat veterans with and without post-traumatic stress disorder

Gene expression analysis in combat veterans with and without post-traumatic stress disorder

Optimal management of night eating syndrome: challenges and solutions

Night eating syndrome: How to treat it?

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