Tourette Updates


CPA: Therapy-resistant Obsessive-Compulsive Patients Respond to
Topiramate
By Louise Gagnon

MONTREAL, QUEBEC -- October 19, 2004 -- Topiramate is effective add-
on therapy for some patients with obsessive-compulsive disorder
(OCD) who have proved resistant to traditional treatment, according
to results of an open-series study presented here at the 54th
Canadian Psychiatric Association Annual Meeting.

"A sub-group of patients…responded to the addition of topiramate in
their therapy," said Michael Van Ameringen, MD, Principal
Investigator and Associate Professor of Psychiatry, Department of
Psychiatry and Behavioural Neurosciences, McMaster University,
Hamilton, Ontario, Canada. "We have taken [patients'] OCD from very
severe to very minimal by adding topiramate to their therapy. It
appears promising."

In 5 men and 11 women with a mean duration of illness of 26.2 years –
the researchers added topiramate at a mean dose of 253.1 mg/day to
selective serotonin reuptake inhibitor (SSRI) monotherapy or SSRI
combination therapy over 14 to 26 weeks. At baseline, the mean
Clinical Global Improvement (CGI) score was 6.1, indicating patients
were regarded as "severely ill".

By the end of the treatment period, 68.8% had a significant drop in
their CGI score. Specifically, 43.8% of subjects had a score of 2,
which indicates they were "much improved," and 25% had a score of 1,
which indicates they were "very much improved."

Dr. Van Ameringen, who is also Co-director of the Anxiety Disorders
Clinic at McMaster University Medical Centre, said that patients
with OCD are typically on SSRIs, which produce response rates of 42%
to 53%.

Dr. Van Ameringen said his team decided to investigate the role of
topiramate therapy in OCD as a result of previous basic science
research showing promise in this area.

"Neuroimaging studies found a deficit in the glutamate system in a
group of children who had [OCD]," he explained. "That may say
something about the neurobiology of the disorder. It made us explore
what agents had an effect on glutamate, such as topiramate."


[Presentation title: "Adding Topiramate to an SRI in Treatment-
Resistant Obsessive-Compulsive Disorder." Abstract 37]
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Scource:
http://www.docguide.com/news/content.nsf/news/8525697700573E1885256F3
2004AD410?
OpenDocument&id=48DDE4A73E09A969852568880078C249&c=Psychiatry%
20Other&count=10
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