Topiramate is an anticonvulsant medication that works by altering neurotransmitter activity to stabilize abnormal electrical activity in the brain. While primarily prescribed to treat seizures in people with epilepsy and to prevent migraines, a new study published in The Primary Care Companion for CNS Disorders examined off-label use of the drug for improving symptoms associated with post-traumatic stress disorder (PTSD).
Topiramate vs Placebo
The researchers conducted a 12-week study with 72 non-veterans who were diagnosed with PTSD. Half received topiramate, while the other half received a placebo. To measure trauma-related symptoms, the researchers administered the Clinician-Administered PTSD Scale (CAPS), a widely used diagnostic tool that evaluates the frequency and intensity of symptoms related to intrusive thoughts, avoidance behaviors, and hyperarousal, among other factors.
The group taking topiramate showed a reduction of 39.5 percent in their total PTSD symptoms. Subjects given the placebo saw a 29.5 percent reduction in symptoms. However, the difference between the two groups were not statistically significant.
The topiramate group also showed some greater improvement in re-experiencing the trauma, avoidance, and hyperarousal. But again, the differences were not statistically significant when compared to placebo.
In terms of safety, the study found that topiramate was generally well-tolerated. The most common side effects reported by both groups were tingling sensations, headaches, fatigue, and difficulty sleeping.
The researchers noted that three times as many patients in the topiramate group saw their PTSD symptoms decrease below the clinical threshold versus to the placebo group. This suggests that the drug does show some promise for treating the condition. Yet again, this difference didn’t reach statistical significance which is why the researchers called for larger studies to confirm the drug’s potential.
The study was notable for using “civilian” subjects versus military veterans. Although veterans are diagnosed with PTSD at a higher rates, it’s a relatively common mental health condition among the general population. According to the National Center for PTSD, about six percent of Americans will experience PTSD at some point in their lives. In veterans, the prevalence is about seven percent. Typical treatments for PTSD include therapies like cognitive behavioral therapy, and medications such as antidepressants.
IN OTHER PSYCHIATRY AND NEUROLOGY NEWS
- New findings highlight the continuous impact of early attachment difficulties on the developmental trajectory of children, including a higher risk of substance abuse and suicide as they get older.
- A boy lived with “The Shadow Man” from age six until he sought treatment at the age of 10. This new case study describes this unusual presentation and explains the cause of long term, persistent hallucinations.
- The CAPRIS study found that, in youth at high risk for psychosis, 50 percent exhibited obsessive-compulsive symptoms and were more likely to present with a more severe clinical and functional profile.
- Khat is an amphetamine-type plant with a psychomotor stimulant effect, native to Africa and the Arabian Peninsula. A study looking at its use among prison inmates in Ethiopia found a strong association between khat use disorder and antisocial personality disorder.
- Earlier this week, the American College of Emergency Physicians (ACEP) reaffirmed its position against use of the phrase “excited delirium,” and withdrew its support for a controversial 2009 paper on the topic.
- Try something new. Join us on Meta Threads and follow @ClinicalPsychiatrist for the latest psychiatry news.
NEW AT CME INSTITUTE
Register Now for Emerging Perspectives in Neurology, a live CME meeting in San Clemente, Calif. worth 5.0 AMA PRA Category 1™ credits.
