Topiramate as an adjuvant treatment for obsessive compulsive symptoms in patients
with bipolar disorder: a randomized double blind placebo controlled clinical
trial.
Author(s): Sahraian A(1), Bigdeli M(1), Ghanizadeh A(2), Akhondzadeh S(3).
Affiliation(s): Author information:
(1)Research Center for Psychiatry and Behavioral Sciences, Department of Psychiatry,
Shiraz University of Medical Sciences, School of Medicine, Shiraz, Iran.
(2)Research Center for Psychiatry and Behavioral Sciences, Department of Psychiatry,
Shiraz University of Medical Sciences, School of Medicine, Shiraz, Iran;
Department of Neuroscience, School of Advanced Medical Sciences and Technologies,
Shiraz University of Medical Sciences, Iran. Electronic address:
ghanizad@sina.tums.ac.ir.
(3)Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical
Sciences, South Kargar Street, Tehran 13337, Iran.
Publication date & source: 2014, J Affect Disord. , 166:201-5
BACKGROUND: It has not been examined trialed whether obsessive compulsive
symptoms in patients with bipolar disorder respond to topiramate as an adjuvant
treatment.
METHODS: This 4-month double-blind placebo-controlled randomized clinical trial
examined the efficacy and safety of augmentation with topiramat for treating the
patients with bipolar disorder, manic phase type-I, and obsessive compulsive
disorder symptoms. Both groups received lithium+olanzapine+clonazepam. However,
one group received topiramate and the other group placebo as adjuvant
medications. Yale Brown obsessive compulsive behavior scale was used to assess
the outcome. Adverse effects were also recorded.
RESULTS: A total of 32 patients completed this trial. The mean score decreased
from 24.2(4.8) to 17.6(8.7) in the topiramate group (P<0.003) and from 20.9(2.9)
to 9.6(3.5) in the placebo group during this trial (P<0.0001). Additionally,
9(52.9%) out of 17 patients in the topiramate group and 2(12.5%) out of 16
patients in the placebo group showed more than 34% decline in YBOC score (x2=6.0,
df=1, P<0.01). No serious adverse effects were detected.
LIMITATIONS: The limitations of the present study were its small sample size and
the fact that it was conducted in a single center.
CONCLUSIONS: The combination of lithium+olanzapine+clonazepam decreased the
symptoms of obsessive compulsive disorder in the patients with bipolar disorder
type I. However, topiramate had a more significant effect than placebo on
improvement of the patients with bipolar disorder and obsessive compulsive
symptoms. This combination seems to be without serious adverse effects.
|
