Topiramate Add-On in Treatment-Resistant Schizophrenia: A Randomized, Double-Blind, Placebo-Controlled, Crossover Trial
J Clin Psychiatry 2005;66(8):1012-1015
© Copyright 2017 Physicians Postgraduate Press, Inc.
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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.