Topiramate add-on in treatment-resistant schizophrenia: a randomized, double-blind, placebo-controlled, crossover trial.

Abstract

OBJECTIVE:

We tested the hypothesis that topiramate is more effective than placebo in reducing symptoms in patients with treatment-resistant schizophrenia when combined with ongoing antipsychotic medication.

METHOD:

Twenty-six hospitalized treatment-resistant patients with chronic DSM-IV-diagnosed schizophrenia participated in a randomized, double-blind, placebo-controlled trial in which 300 mg/day of topiramate was gradually added to their ongoing treatment (clozapine, olanzapine, risperidone, or quetiapine) over two 12-week crossover treatment periods. Data were collected from April 2003 to November 2003.

RESULTS:

In intention-to-treat analysis, topiramate was more effective than placebo in reducing Positive and Negative Syndrome Scale general psychopathologic symptoms (effect size = 0.7, p = .021), whereas no significant improvement was observed in positive or negative symptoms.

CONCLUSION:

Glutamate antagonist topiramate may be an effective adjuvant treatment in reducing general psychopathologic symptoms in patients with schizophrenia resistant to treatment with second-generation antipsychotics.

• Authors: Jari Tiihonen, Pirjo Halonen, Kristian Wahlbeck, Eila Repo-Tiihonen, Soile Hyvärinen, Markku Eronen, Hanna Putkonen, Pirjo Takala, Olli-Pekka Mehtonen, Martin Puck, Jorma Oksanen, Pasi Koskelainen, Grigori Joffe, Juhani Aer, Tero Hallikainen, Olli-Pekka Ryynänen, Erkki Tupala
• Journal: The Journal of clinical psychiatry (J Clin Psychiatry) Vol. 66 Issue 8 Pg. 1012-5 (Aug 2005) ISSN: 0160-6689 [Print] United States
• PMID: 16086616 (Publication Type: Clinical Trial, Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anticonvulsants
• Antipsychotic Agents
• Placebos
• Topiramate
• Fructose

Topics

• Adult
• Anticonvulsants (therapeutic use)
• Antipsychotic Agents (therapeutic use)
• Cross-Over Studies
• Double-Blind Method
• Drug Therapy, Combination
• Female
• Fructose (analogs & derivatives, therapeutic use)
• Humans
• Male
• Middle Aged
• Placebos
• Psychiatric Status Rating Scales
• Schizophrenia (diagnosis, drug therapy)
• Schizophrenic Psychology
• Topiramate
• Treatment Outcome