Premium
Lithium augmentation of topiramate for bipolar disorder with comorbid binge eating disorder and obesity
Author(s) -
Kotwal Renu,
Guerdjikova Anna,
McElroy Susan L.,
Keck Paul E.
Publication year - 2006
Publication title -
human psychopharmacology: clinical and experimental
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.461
H-Index - 78
eISSN - 1099-1077
pISSN - 0885-6222
DOI - 10.1002/hup.783
Subject(s) - topiramate , bipolar disorder , lithium (medication) , mood , binge eating , binge eating disorder , obesity , weight loss , mood disorders , psychology , mood stabilizer , psychiatry , medicine , eating disorders , bulimia nervosa , anxiety , epilepsy
Objective To evaluate the effectiveness of lithium augmentation of topiramate on mood symptoms, binge eating behavior, and body weight in obese bipolar patients with binge eating disorder (BED) seeking weight management. Method We conducted a naturalistic study of 12 consecutive outpatients with bipolar disorders, BED, and obesity who received lithium augmentation for mood instability during the course of topiramate‐based pharmacotherapy for obesity and BED. Lithium was added to topiramate (mean dose 514 mg i.d.) and titrated to a mean dose of 1009 mg i.d. (mean plasma concentration 0.7 mmol/L). Treatment response was assessed by comparing changes in clinical severity scales for mood and eating disorders, weekly binge eating frequency, and weight for the 2 months before and the first 2 months during lithium treatment. Results A statistically significant improvement in global severity of mood symptoms was observed after as compared to before lithium augmentation. Statistically insignificant reductions in weight and in binge frequency and severity were also observed after lithium addition. Conclusion Optimal weight loss treatment in obese patients with comorbid bipolar and BEDs may require stabilization of mood. The combination of lithium and topiramate may have a role in the management of this difficult‐to‐treat population. Copyright © 2006 John Wiley & Sons, Ltd.