Add-on topiramate for the pharmacological management of schizophrenia: a double blind randomized clinical trial

ABSTRACT

Glutamate antagonists including anticonvulsant topiramate have been recommended for the pharmacological management of schizophrenia. A randomized, double-blind, placebo controlled clinical trial was performed on 32 patients diagnosed with schizophrenia [18-45 years old]. Baseline information was gathered on demographic characteristics, vital signs, height, weight, smoking habit, [past] psychiatric history, drug history and adverse effects to medication. Patients were randomly assigned to topiramate group [n=16] or placebo one [n=16]. Positive and negative syndrome scale [PANSS] was administered on each patient at baseline, on days 28 and 56. The mean total PANSS score in topiramate group was 96.87 [85.37-108.37] at baseline, 85.68 [74.67-96.70] on day 28 and 76.87[66.06-87.69] on day 56. These were 101.87 [90.37-113.37], 100.31 [89.29- 111.32] and 100.56 [89.74-111.37] respectively in placebo group. General linear model for repeated measure analysis showed that topiramate has lowered PANSS score significantly. Significant decline was also found in all three PANSS components [negative, positive and psychopathology symptoms]. Topiramate can therefore be used as an effective add-on medication in treating schizophrenia