To assess the efficacy and safety of topiramate in treating binge eating disorder (BED), using a systematic review and meta-analysis of the available randomized clinical trials (RCTs).

The RCTs assessing topiramate vs placebo with or without adjunctive psychotherapy in BED were reviewed using a systematic search in the PubMed, Web of Science, PsycINFO, Cochrane Database of Systematic Review, and ClinicalTrials.gov search Websites, from inception to November 2019. Main outcomes were the changes in binge frequency, quality of life, and weight, respectively. Effect estimates were pooled using random-effect models and presented as risk ratios (RRs) or mean differences (MDs) and their 95% confidence interval (95% CI). Data extraction was performed by two independent reviewers.

Three studies were eligible for inclusion, involving 528 BED patients. Topiramate was found to be significantly more efficacious than placebo in reducing: (a) the number of binge episodes per week (MD = −1.31; 95% CI = −2.58 to −0.03; I2 = 94%); (b) the number of binge days per week (MD = −0.98; 95% CI = −1.80 to −0.16; I2 = 94%); and (c) weight (MD = −4.91 kg; 95% CI = −6.42 to −3.41; I2 = 10%). However, participants in the topiramate groups withdrew significantly more frequently for safety reasons, relative to placebo participants (RR = 1.90; 95% CI = 1.13-3.18, I2 = 0%).

Preliminary findings support a possible efficacy of topiramate for the treatment of BED, even if safety concerns could limit the practical use of this treatment in BED subjects.

Medication compliance is associated with the treatment outcomes. The reported consequences of non-compliance are chronification, poor psychosocial outcomes and increased suicide rates. We measured the drug compliance using medication event monitoring system (MEMS) and several compliance measures in the outpatients with depressive disorders. In addition, we tried to find out the relationship of antidepressant compliance with other clinical correlates including insight in depressive disorders.

This study was performed in Korea university medical center, Guro hospital. Outpatients diagnosed as having depressive disorders were enrolled. Monitoring was performed in 76 depressive patients who were taking the mono-antidepressant therapy during the at least 4-week evaluation period. 17 item Hamilton Rating Scale for Depression (HRSD), Multidimensional Scale of Perceived Social Support (MSPSS) and the mood disorders insight scale (MDIS) were investigated. Compliance was measured using MEMS, clinician rating scale of antidepressant compliance, pill count, and patient's self-report.

A total of 76 outpatients were enrolled in this study. As the severity of depression increases, patients tended to perceive poor social support from others in the correlation analysis. Level of depression by HRSD was significantly correlated with MDIS scores. Compliance rates for MEMS, pill count, clinician rating scale of compliance and self-report were 51.9%, 71.4%, 79.2% and 75.3% respectively. We did not find any statistical significance between compliance variables and other clinical scale scores (MDIS, HRSD, and MSPSS).

More severely depressed patients have higher scores of insight in case of depression. However, increased perception of insight in depressive patients was not directly related with the increase in treatment compliance. Further investigation is needed to understand other factors affecting the drug compliance especially in depressive patients.

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This study was carried out on 149 of Heroin dependent patient that admission for detoxification.

This study is a 10 days double blind placebo-controlled trial.

This study is a 10 days double blind placebo-controlled trial which was carried out on 149 of Heroin dependent patient that admission for detoxification in Mashhad Ebne-sina hospital in 1385-1386 Subjects were randomly divided into topiramate and placebo detoxification groups.

Topiramate group receive topiramate (max 200 mg) for 10 days. The placebo group received usual regimen and placebo. Withdrawal symptoms were assessed by Subjective and Objective Opiate Withdrawal Scale in days 1, 3, 5, 7, 10.information s analyzed by chi-square test for qualities variables and T-test & Mann-Whitney for quantities variables in SPSS software.

22 subjects were excluded from the study. Both groups had no significant differences in age, sex, education, number of previous withdrawal and past history of other drug use. Result indicates decrease in objective withdrawal symptom significant in 3(p=0.000), 5 (p=0.004) and 7(p=0.026) day and subjective withdrawal symptom significant in 3 (p=0.000) day in topiramate groups.

Topiramate can use for control of withdrawal symptom in patient with Heroin dependency.

We previously tested topiramate, an anticonvulsant, in the treatment of aggression in men with borderline personality disorder (BPD) (Nickel M, Nickel C, Kaplan P, Lahmann C, Mühlbacher M, Tritt K, et al. Treatment of aggression with topiramate in male borderline patients: a double-blind, placebo-controlled study. Biol Psychiatry 2005;57:495–9), and found significant changes on most scales of the state–trait anger expression inventory (STAXI) and significant weight loss eight weeks later. The aim of this trial was to assess topiramate's efficacy in the long-term therapy for aggression in men with BPD.

This 18-month follow-up observation, in which the previous patients (topiramate group: n = 22; former placebo group: n = 22) were examined bianually, was carried out.

According to the intent-to-treat principle, significant changes on all scales of the STAXI were observed in the subjects treated with topiramate. Additional significant weight loss was observed. All subjects tolerated topiramate relatively well.

Topiramate appears to be an effective, relatively safe agent in the long-term treatment of patients with BPD. Mild, non-transient weight loss can be expected.