Topamax for Bipolar Disorder

Some clinical studies suggest that it might be beneficial to use Topamax for bipolar disorder treatment, especially in obese people. In these studies, when the drug was taken with other bipolar medications, it was shown to help improve both mania and depression symptoms. However, the medication is not approved to treat bipolar disorder.

Topamax for Bipolar Disorder: An Overview

Topamax® (topiramate) is a prescription medication used to treat epilepsy and to prevent migraine headaches. Although it is not approved for this use, early studies suggested that Topamax may be useful in treating bipolar disorder, especially in obese people. Later studies, however, have not confirmed the results of these earlier studies.

What Is Bipolar Disorder?

Bipolar disorder, also known as manic depression, is a serious brain disease that causes extreme shifts in mood, energy, and functioning. Currently, it is thought that bipolar disorder may be at least partially genetic (see Bipolar Causes). This condition is different from the normal ups and downs that everyone goes through -- the symptoms of bipolar disorder are more severe. Episodes of mania and depression typically recur throughout the affected person's lifespan. Between episodes, most people with this disorder are free of symptoms (see Bipolar Disorder Symptoms).

Research on Treating Bipolar Disorder With Topamax

Several studies have been conducted on the effects of Topamax for bipolar disorder. Some studies looked at the effects on bipolar symptoms when the drug was taken alone, while other studies looked at adding Topamax to other bipolar disorder medications.
The manufacturer conducted several studies looking at the effectiveness of Topamax to treat acute mania or mixed episodes in adults with bipolar disorder. These studies showed that Topamax by itself was not effective in treating bipolar symptoms. The results were published in the February 2006 Bipolar Disorder journal.
In several small studies looking at Topamax combined with other bipolar medications, Topamax was shown to help improve both mania and depression symptoms. However, in a larger study that included a group not taking Topamax (this is known as a placebo-controlled study), no difference was seen in symptoms with the group taking Topamax compared to the group not taking the medication. This study was published in the November 2006 Journal of Clinical Psychiatry.
Because Topamax can be effective for weight loss, several studies have focused on obese people with bipolar disorder. Several of these studies showed that Topamax helped these people lose weight, and some studies showed that the drug improved their bipolar symptoms. Larger studies are needed to confirm these results.
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