by David Douglas

Last Updated: 2007-10-19 19:26:50 -0400 (Reuters Health)

NEW YORK (Reuters Health) – Topiramate appears to be a worthwhile adjunct to cognitive-behavior therapy (CBT) in patients with binge-eating disorder, particularly in regard to weight loss, according to Brazilian researchers.

"Our findings," lead investigator Dr. Angelica M. Claudino told Reuters Health, "enhance the idea that treating patients with complex diseases such as obesity-associated eating disorders must focus on multiple aspects — behavioral, psychological and somatic."

In the September issue of the Journal of Clinical Psychiatry, Dr. Claudino of the Federal University of Sao Paulo and colleagues note that although CBT for binge eating has shown positive results in dealing with associated psychopathology, the impact on weight is usually low.

To examine whether the addition of topiramate might be helpful in these circumstances, the researchers randomized 73 outpatients with a body mass index of at least 30 to topiramate (target daily dose 200 mg) or placebo, along with a total of 19 sessions of group CBT.

In all, 56 patients (76.7%) completed the 21-week double-blind study. Topiramate patients lost a mean of 6.8 kg compared to 0.9 kg seen in placebo patients.

Moreover, although the difference did not reach statistical significance, 31 of the 37 topiramate patients achieved binge remission compared to 22 of the 36 placebo patients.

These results, the researchers conclude, "suggest that the addition of topiramate can enhance the benefits of CBT by promoting a clinically significant weight reduction and greater remission of binge eating in the short run."

Dr. Claudino added, "Although limited by its short duration, our study suggests that combined interventions such as the one we tested seem to be promising options to be pursued as we try to approach these disorders in a more comprehensive way."

J Clin Psychiatry 2007;68:1324-1332.