I just did a scan of the medline literature on Topamax. This is an FDA approved drug for epilepsy, and I don\'t think any large scale studies have been done on weight loss. When it is used with bipolar patients, weight loss is see as a side effect. I also did not find any studies on depression and Topamax. It did seem to help migraine. The side effects include psychosis, confusion, and 2-4 times the risk of kidney stones. My overall impression is that this is a drug in its \"honeymoon\" period and we don\'t have any good data on what the long term effects will be.

I hope this is helpful. I\'m attaching relevant abstracts. Christopher Maloney, Naturopathic Doctor Augusta and Portland, Maine www.maloneymedical.com Individualized research available for a fee. Informational only, I cannot treat or diagnose via the web.

Ned Tijdschr Geneeskd. 2002 Nov 2;146(44):2093-5. Related Articles, Links

Comment in: Ned Tijdschr Geneeskd. 2003 Feb 15;147(7):319-20; author reply 320.

[Psychosis following treatment with topiramate]

[Article in Dutch]

Verhoeven WM, Boermans JA, van der Heijden FM, Tuinier S.

Vincent van Gogh Instituut voor Psychiatrie, Stationsweg 46, 5803 AC Venray.

In three patients, two men aged 33 and 43 years receiving treatment for epilepsy, and one woman aged 31 years with mild mental retardation and psychotic episodes, psychotic symptoms emerged soon after the introduction of topiramate. These symptoms were associated with agitation/aggressive behaviour and significant weight loss. Psychotic symptomatology gradually disappeared after discontinuation of topiramate without the administration of an antipsychotic. Over the past years several novel anticonvulsants, including topiramate, have become available for the treatment of refractory partial seizures, with or without secondary generalisation. Some of them have been demonstrated to be effective in bipolar affective disorders as well. Treatment with topiramate can be associated with neuropsychiatric side-effects such as cognitive impairments, deficits in word finding, and incidental psychotic decompensation. Significant weight loss is often noted as well. Since psychiatric and cognitive side-effects may occur during treatment with topiramate, careful evaluation is mandatory especially in patients with a psychiatric history.

Publication Types: Case Reports

PMID: 12448965 [PubMed - indexed for MEDLINE]