Treatment of Bulimia Nervosa With Topiramate in a Randomized, Double-Blind, Placebo-Controlled Trial, Part 1: Improvement in Binge and Purge Measures
J Clin Psychiatry 2003;64(11):1335-1341
© Copyright 2014 Physicians Postgraduate Press, Inc.
Purchase This PDF for $40.00
If you are not a paid subscriber, you may purchase the PDF.
(You'll need the free Adobe Acrobat Reader.)
Receive immediate full-text access to JCP. You can subscribe to JCP online-only ($86) or print + online ($156 individual).
With your subscription, receive a free PDF collection of the NCDEU Festschrift articles. Hurry! This offer ends December 31, 2011.
If you are a paid subscriber to JCP and do not yet have a username and password, activate your subscription now.
As a paid subscriber who has activated your subscription, you have access to the HTML and PDF versions of this item.
Click here to login.
Did you forget your password?
Still can't log in? Contact the Circulation Department at 1-800-489-1001 x4 or send email
Background: This randomized, double-blind,
placebo-controlled trial was designed to assess the efficacy and
safety of topiramate in bulimia nervosa.
Method: Patients with DSM-IV bulimia nervosa
were randomly assigned in equal proportions to receive topiramate
(N = 35) or placebo (N = 34) for 10 weeks (between April 1999 and
Dec. 2000). Topiramate treatment was started at 25 mg/day and
titrated by 25 to 50 mg/week to a maximum of 400 mg/day. The
primary efficacy measure was mean weekly number of binge and/or
purge days. Related outcome measures included mean weekly number
of binge days and binge frequency, as well as mean weekly number
of purge days and purge frequency.
Results: Sixty-four outpatients (33 placebo, 31
topiramate) were included in the intent-to-treat analysis. The
median topiramate dose was 100 mg/day (range, 25-400 mg/day).
Mean ± SD baseline number of weekly binge and/or purge days was
5.0 ± 1.6 for topiramate patients and 5.1 ± 1.5 for placebo
patients. The primary efficacy measure, mean weekly number of
binge and/or purge days, decreased 44.8% from baseline with
topiramate versus 10.7% with placebo (p = .004). The mean weekly
number of binge days decreased 48.2% with topiramate versus 17.7%
with placebo (p = .015), and mean binge frequency decreased 49.2%
with topiramate versus 28.0% with placebo (p = .071). The mean
weekly number of purge days decreased 43.4% with topiramate
versus 16.6% with placebo (p = .016), and mean purge frequency
decreased 49.8% with topiramate versus 21.6% with placebo (p =
.016). Three patients (2 placebo, 1 topiramate) discontinued from
the trial due to adverse events.
Conclusion: Topiramate was associated with
significant improvements in both binge and purge symptoms in this
study population and represents a potential treatment for bulimia