Psychiatrist.comTopiramate Monotherapy for Civilian Posttraumatic Stress Disorder: A Controlled Pilot Study

Topiramate Shows Promise in Reducing PTSD Symptoms

A recent study investigated the efficacy and safety of topiramate monotherapy in treating civilian posttraumatic stress disorder (PTSD). The study was a double-blind, placebo-controlled trial involving outpatients aged between 18 and 64 years.

Study Design

• The study involved outpatients aged between 18 and 64 years with DSM-IV non-combat-related PTSD.
• Participants were required to have Clinician-Administered PTSD Scale (CAPS) scores of 50 or higher.
• Topiramate was started at 25 mg/day and titrated by 25-50 mg/week to 400 mg/day or maximum tolerated dose.
• Data were collected between April 26, 2002, and February 4, 2004.

Key Findings

• The intent-to-treat (ITT) population comprised 38 patients with mean baseline total CAPS scores of 88.3 (topiramate, N = 19) and 91.1 (placebo, N = 19).
• Although a decrease in total CAPS score was noted (topiramate, -52.7; placebo, -42.0), this difference was not statistically significant (p = .232).
• Topiramate-treated patients exhibited significant reductions in reexperiencing symptoms (CAPS cluster B: topiramate, 74.9%; placebo, 50.2%; p = .038) and Treatment Outcome PTSD scale (topiramate, 68.0%; placebo, 41.6%; p = .025).

According to the National Institute of Mental Health, about 3.6% of US adults had PTSD in the past year.

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