Topiramate in treatment of depressive and anger symptoms in female depressive patients: A randomized, double-blind, placebo-controlled study

Nickel, Cerstin; Lahmann, Claas; Tritt, Karin; Muehlbacher, Moritz; Kaplan, Patrick; Kettler, Christian; Krawczyk, Jakub; Loew, Thomas H.; Rother, Wolfhardt K.; Nickel, Marius

doi:10.1016/j.jad.2005.04.003

Cited by 51 publications

(22 citation statements)

References 33 publications

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“…Preliminary studies have found some support for the use of TPM as a treatment for anxiety and mood disorders (Bahk et al, 2005;Berlant and van Kammen, 2002;McIntyre et al, 2002;Nickel et al, 2005). However reviews of these reports suggest they offer enough evidence to warrant more comprehensive large double-blind studies without themselves providing clear evidence of efficacy (Suppes, 2002;Vasudev et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

“…Preliminary clinical trials have found TPM has potential in treating posttraumatic stress disorder (PTSD; Berlant and van Kammen, 2002;Tucker et al, 2007) and in acute mania, depression, and mixed states (Bahk et al, 2005;McIntyre et al, 2002McIntyre et al, , 2005Nickel et al, 2005). However, not all studies have been positive (e.g., Kushner et al, 2006) and much of the supportive evidence comes from case studies and open label studies.…”

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confidence: 99%

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Topiramate Moderately Reduces the Motivation to Consume Alcohol and Has a Marked Antidepressant Effect in Rats

Hargreaves

McGregor

2007

Alcoholism Clin & Exp Res

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With acute administration, TPM is moderately effective and relatively selective in reducing the drive to consume alcohol in Wistar rats. This anti-alcohol effect is modest in comparison with naloxone and appears to dissipate under conditions of chronic treatment and ad libitum alcohol access. A marked antidepressant-like effect in the forced swim test and partial anxiolytic effects in other animal models suggests that TPM may be a beneficial treatment for affective disorders. These preliminary results suggest further research is warranted to resolve the mechanisms involved in TPM modulation of both mood and alcohol consumption.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Topiramate Moderately Reduces the Motivation to Consume Alcohol and Has a Marked Antidepressant Effect in Rats

Hargreaves

McGregor

2007

Alcoholism Clin & Exp Res

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“…In our other study, improvement of depression could be demonstrated with topiramate therapy. 33 This was possibly due to the very moderate proportion of patients with personality disorders in the other study.…”

Section: Discussionmentioning

confidence: 75%

Topiramate Treatment for Women With Borderline Personality Disorder

Loew¹,

Nickel²,

Muehlbacher³

et al. 2006

Journal of Clinical Psychopharmacology

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122

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Borderline personality disorder is a common and severe psychiatric illness. The goal of this study was to determine whether topiramate can influence patients' borderline psychopathology, health-related quality of life, and interpersonal problems. Women meeting the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Structured Clinical Interview II criteria for borderline personality disorder were randomly assigned in a 1:1 ratio to topiramate titrated from 25 to 200 mg/d (n = 28) or placebo (n = 28) for 10 weeks. Primary outcome measures were changes on the Symptom-Checklist, on the SF-36 Health Survey, and on the Inventory of Interpersonal Problems. Body weight and additional side effects were assessed weekly. According to the intent-to-treat principle, significant changes (all P < 0.001) on the somatization, interpersonal sensitivity, anxiety, hostility, phobic anxiety, and Global Severity Index scales of the Symptom Checklist were observed in the topiramate-treated subjects after 10 weeks (no significant changes on the obsessive-compulsive, depression, paranoid ideation, and psychoticism scales). In the SF-36 Health Survey, significant differences were observed on all 8 scales (all P < 0.01 or P < 0.001). In the Inventory of Interpersonal Problems, significant differences (all P < 0.001) were found in the scales for overly autocratic, overly competitive, overly introverted, and overly expressive (no significant differences in the scales for overly cold, overly subassertive/subservient, overly exploitable/compliant, and overly nurturant/friendly). Weight loss was additionally observed (p < 0.001). Topiramate appears to be a safe and effective agent in the treatment in women with borderline personality disorder. Additional weight loss can be expected.

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“…The outcome of a double-blind, placebo-controlled RCT indicates the efficacy of topiramate monotherapy in reducing depressive symptoms and anger in female patients with TRD. [369] In that study, the drug was very well tolerated; its main treatmentemergent adverse event was weight loss. Some patients with bipolar disorders who were treated with topiramate to control irritability and racing thoughts developed depressive symptoms after initiating treatment.…”

Section: Topiramatementioning

confidence: 96%

Therapeutic Options for Treatment-Resistant Depression

Shelton

Osuntokun

Heinloth³

et al. 2010

CNS Drugs

186

137

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Treatment-resistant depression (TRD) presents major challenges for both patients and clinicians. There is no universally accepted definition of TRD, but results from the US National Institute of Mental Health's (NIMH) STAR*D (Sequenced Treatment Alternatives to Relieve Depression) programme indicate that after the failure of two treatment trials, the chances of remission decrease significantly. Several pharmacological and nonpharmacological treatments for TRD may be considered when optimized (adequate dose and duration) therapy has not produced a successful outcome and a patient is classified as resistant to treatment. Nonpharmacological strategies include psychotherapy (often in conjunction with pharmacotherapy), electroconvulsive therapy and vagus nerve stimulation. The US FDA recently approved vagus nerve stimulation as adjunctive therapy (after four prior treatment failures); however, its benefits are seen only after prolonged (up to 1 year) use. Other nonpharmacological options, such as repetitive transcranial stimulation, deep brain stimulation or psychosurgery, remain experimental and are not widely available. Pharmacological treatments of TRD can be grouped in two main categories: 'switching' or 'combining'. In the first, treatment is switched within and between classes of compounds. The benefits of switching include avoidance of polypharmacy, a narrower range of treatment-emergent adverse events and lower costs. An inherent disadvantage of any switching strategy is that partial treatment responses resulting from the initial treatment might be lost by its discontinuation in favour of another medication trial. Monotherapy switches have also been shown to have limited effectiveness in achieving remission. The advantage of combination strategies is the potential to build upon achieved improvements; they are generally recommended if partial response was achieved with the current treatment trial. Various non-antidepressant augmenting agents, such as lithium and thyroid hormones, are well studied, although not commonly used. There is also evidence of efficacy and increasing use of atypical antipsychotics in combination with antidepressants, for example, olanzapine in combination with fluoxetine (OFC) or augmentation with aripiprazole. The disadvantages of a combination strategy include multiple medications, a broader range of treatment-emergent adverse events and higher costs. Several experimental pharmaceutical treatment alternatives for TRD are also being explored in combination with antidepressants or as monotherapy. These less studied alternative compounds include pindolol, inositol, CNS stimulants, hormones, herbal supplements, omega-3 fatty acids, S-adenosyl-L-methionine, folic acid, lamotrigine, modafinil, riluzole and topiramate. In summary, despite an increasing variety of choices for the treatment of TRD, this condition remains universally undefined and represents an area of unmet medical need. There are few known approved pharmacological agents for TRD (aripiprazole and OFC) and overall outcomes rema...

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Topiramate in treatment of depressive and anger symptoms in female depressive patients: A randomized, double-blind, placebo-controlled study

Cited by 51 publications

References 33 publications

Topiramate Moderately Reduces the Motivation to Consume Alcohol and Has a Marked Antidepressant Effect in Rats

Topiramate Moderately Reduces the Motivation to Consume Alcohol and Has a Marked Antidepressant Effect in Rats

Topiramate Treatment for Women With Borderline Personality Disorder

Therapeutic Options for Treatment-Resistant Depression

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