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Influence of topiramate on olanzapine-related adiposity in women: a random, double-blind, placebo-controlled study.

Clinic for Psychosomatic Medicine, Inntalklinik, Simbach/Inn, Germany.
Journal of Clinical Psychopharmacology (Impact Factor: 3.76). 07/2005; 25(3):211-7.
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ABSTRACT The aim of this study was to compare the efficacy of topiramate versus a placebo in the treatment of adiposity in women undergoing olanzapine therapy. We also assessed changes health-related quality of life, the patient's actual state of health, and psychologic impairments. The 10-week, random, double-blind, placebo-controlled study included 43 women who had been treated with olanzapine (mean dose 7.8 +/- 3.6 in the topiramate group and 7.2 +/- 3.1 in the placebo group) and had gained weight as a side effect. The subjects were randomly assigned to topiramate (n = 25) or a placebo (n = 18). Primary outcome measures were weight checks and self-reported changes on the scales of the SF-36 Health Survey, Bf-S Scale of Well-Being, and the Adjective Checklist EWL-60-S. Weight loss was observed and was significantly more pronounced in the topiramate-treated group (difference in weight loss between the 2 groups: 5.6 kg, 95% CI = -8.5, -3.0, P < 0.001). In comparison with the placebo group, significant changes on 7 (7/8) scales of SF-36 Health Survey (all P < 0.001), on all 6 scales of the EWL-60-S, and on the Bf-S were observed in the topiramate-treated subjects after 10 weeks. All patients tolerated topiramate well. Topiramate appears to be a safe and effective agent in the treatment of weight gain that occurred during olanzapine treatment. Significantly positive changes in health-related quality of life, the patient's actual state of health, and psychologic impairments were observed.

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    • "Thus, the total number of study arms (N ¼ 32 + 2 ¼ 34) and patients (n ¼ 1482 + 82 ¼ 1564) in the analyses is higher than the total number of studies (N ¼ 32) and patients (n ¼ 1482). To examine potential moderator variables, four sensitivity analyses were performed: (1) intervention studies (N ¼ 22, n ¼ 947) (Arman et al, 2008; Assuncao et al, 2006; Atmaca et al, 2003, 2004; Baptista et al, 2007, 2008b, 2009; Borovicka et al, 2002; Bustillo et al, 2003; Carrizo et al, 2009; Deberdt et al, 2005; Goodall et al, 1988; Graham et al, 2005; Henderson et al, 2005, 2007, 2009; Joffe et al, 2008; Klein et al, 2006; Ko et al, 2005; Modell and Hussar, 1965; Nickel et al, 2005; Wu et al, 2008b), that is, weight loss agent given after weight gain with antipsychotic treatment, vs prevention studies (N ¼ 10, n ¼ 535) (Baptista et al, 2006; Cavazzoni et al, 2003; Hinze-Selch et al, 2000; Kim et al, 2006; Lu et al, 2004; Poyurovsky et al, 2002, 2003, 2004, 2007; Wu et al, 2008a), that is, weight loss agent was given concomitantly with newly initiated antipsychotic treatment; (2) short-term trials of p8 weeks (N ¼ 10, n ¼ 296) (Atmaca et al, 2003, 2004; Henderson et al, 2009; Hinze-Selch et al, 2000; Modell and Hussar, 1965; Nickel et al, 2005; Poyurovsky et al, 2002, 2003, 2004, 2007) vs medium-term trials of 12–16 weeks (N ¼ 22, n ¼ 1186) (Arman et al, 2008; Assuncao et al, 2006; Baptista et al, 2006, 2007, 2008b, 2009; Borovicka et al, 2002; Bustillo et al, 2003; Carrizo et al, 2009; Antipsychotic-related weight gain and metabolic abnormalities L Maayan et al Cavazzoni et al, 2003; Deberdt et al, 2005; Goodall et al, 1988; Graham et al, 2005; Henderson et al, 2005, 2007; Joffe et al, 2008; Kim et al, 2006; Klein et al, 2006; Ko et al, 2005; Lu et al, 2004; Wu et al, 2008a,b); (3) outpatient status (N ¼ 12, n ¼ 454) (Assuncao et al, 2006; Borovicka et al, 2002; Bustillo et al, 2003; Carrizo et al, 2009; Goodall et al, 1988; Graham et al, 2005; Henderson et al, 2005, 2007, 2009; Kim et al, 2006; Nickel et al, 2005; Wu et al, 2008b) vs inpatient status (N ¼ 14, n ¼ 514) (Arman et al, 2008; Baptista et al, 2006, 2008b, 2009; Hinze-Selch et al, 2000; Klein et al, 2006; Ko et al, 2005; Lu et al, 2004; Modell and Hussar, 1965; Poyurovsky et al, 2002, 2003, 2004, 2007; Wu et al, 2008a) vs mixed status (N ¼ 6, n ¼ 514) (Atmaca et al, 2003, 2004; Baptista et al, 2007; Cavazzoni et al, 2003; Deberdt et al, 2005; Joffe et al, 2008); and (4) adults with chronic antipsychotic treatment (N ¼ 23, n ¼ 1149) (Assuncao et al, 2006; Atmaca et al, 2003, 2004; Baptista et al, 2006, 2007, 2008b, 2009; Borovicka et al, 2002; Carrizo et al, 2009; Cavazzoni et al, 2003; Deberdt et al, 2005; Goodall et al, 1988; Graham et al, 2005; Henderson et al, 2005, 2007, 2009; Hinze-Selch et al, 2000; Joffe et al, 2008; Kim et al, 2006; Ko et al, 2005; Lu et al, 2004; Modell and Hussar, 1965; Nickel et al, 2005) vs first episode or youth samples (N ¼ 9, n ¼ 333) (Arman et al, 2008; Bustillo et al, 2003; Klein et al, 2006; Poyurovsky et al, 2002, 2003, 2004, 2007; Wu et al, 2008a,b). "
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