Document Detail


Weight reducing and metabolic effects of topiramate in patients with migraine--an observational study.
MedLine Citation:
PMID:  20200812     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Topiramate is an anticonvulsant agent effective in the prophylaxis of migraine, which also induces weight reduction by an unknown mechanism. We investigated the effect of topiramate on metabolic and endocrine parameters in patients with migraine independently of any intention to lose body weight. Six patients (26-61 years old, body mass indices [BMI] 20.9-32.1 kg/m(2)) with migraine were treated with an average dose of 100 mg topiramate/day over a period of 20 weeks. The following parameters were measured every 4-8 weeks: BMI, body fat proportion, waist and hip circumference, HOMA insulin resistance, fasting serum-/plasma concentrations of adiponectin, leptin, ghrelin, vascular endothelial growth factor (VEGF), cortisol, interleukin-6 and tumor necrosis factor (TNF)-alpha. Profound metabolic changes were observed for the whole treatment period. Compared with the baseline value, 20 weeks of treatment reduced the BMI by 7.2+/-1.4%, body fat proportion by 11.6+/-3.6%, waist circumference by 4.2+/-1.2%, leptin by 39.2+/-6.5% and HOMA insulin resistance by 37.3+/-5%, while adiponectin was increased by 69.9+/-17.3% (P<0.05, respectively). VEGF concentrations increased during the week 2-4 by 177.4+/-39.4% (P<0.05) followed by a continuous decrease. There were trends for a reduction in ghrelin concentration, whereas cortisol, interleukin-6 and TNF-alpha values were unchanged. In summary, in this small sample of migraine patients topiramate treatment was associated with increased insulin sensitivity, increased adiponectin concentration and a reduction of body fat in all treated patients. The role of increased VEGF concentrations prior to these metabolic changes is not clear and might, hypothetically, involve a centrally mediated effect of topiramate on body weight regulation.
Authors:
M Schütt; J Brinkhoff; M Drenckhan; H Lehnert; C Sommer
Publication Detail:
Type:  Journal Article     Date:  2010-03-03
Journal Detail:
Title:  Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association     Volume:  118     ISSN:  1439-3646     ISO Abbreviation:  Exp. Clin. Endocrinol. Diabetes     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-07-09     Completed Date:  2010-10-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9505926     Medline TA:  Exp Clin Endocrinol Diabetes     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  449-52     Citation Subset:  IM    
Copyright Information:
J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart, New York.
Affiliation:
Department of Internal Medicine I, University of Lübeck, Lübeck, Germany. morten.schuett@uk-sh.de
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MeSH Terms
Descriptor/Qualifier:
Adiponectin / blood
Adipose Tissue / drug effects
Adult
Anti-Obesity Agents / administration & dosage*
Anticonvulsants / administration & dosage*
Body Mass Index
Cytokines / blood
Female
Fructose / administration & dosage,  analogs & derivatives*
Hip
Humans
Insulin Resistance
Leptin / blood
Male
Middle Aged
Migraine Disorders / drug therapy*
Prospective Studies
Vascular Endothelial Growth Factors / blood
Waist Circumference / drug effects
Weight Loss / drug effects*
Chemical
Reg. No./Substance:
0/Adiponectin; 0/Anti-Obesity Agents; 0/Anticonvulsants; 0/Cytokines; 0/Leptin; 0/Vascular Endothelial Growth Factors; 30237-26-4/Fructose; 97240-79-4/topiramate

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