Weight regain after discontinuation of topiramate treatment in patients with migraine: A prospective observational study

Alberto Verrotti, Pasquale Parisi, Sergio Agostinelli, Giulia Loiacono, Francesca Marra, Giangennaro Coppola, Laura Rosa Pisani, Gaetano Gorgone, Pasquale Striano, Francesco Pisani, Vincenzo Belcastro

Research output: Contribution to journalArticle

Abstract

Purpose: To monitor weight regain after therapy discontinuation in patients with migraine experiencing weight loss during topiramate (TPM) treatment. Methods: Patients with migraine without aura were enrolled in this observational prospective study. Weight, body mass index (BMI), waist circumference, systolic and diastolic blood pressure, plasma levels of total cholesterol, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, triglycerides, leptin, and ghrelin, and homeostatic model assessment of insulin resistance (HOMA-IR) were evaluated before starting TPM (T1), at 3 (T2) and 6 (T3) months of treatment and 6 months after withdrawal of TPM (T4). Weight loss/regain was considered as a change of 5 % of pre-TPM body weight. Results: A total of 241 patients were analyzed. Of these, 87 (36 %) patients experienced weight loss on TPM medication. During TPM therapy significant reductions in mean values of weight (p <0.001), BMI (p <0.001), waist circumference (p <0.01), HOMA-IR (p <0.01), and leptin (p <0.01) were observed. After TPM discontinuation, all of these parameters showed a clear trend to increase at T4, achieving pre-TPM values in 27 patients. Among potential predictors, only HOMA-IR before starting TPM (parameter estimate = 1.36, effect size = 0.75; p = 0.006) was significantly associated with weight regain after therapy discontinuation. Conclusions: Loss of body weight is a reversible effect, which at 6 months after TPM discontinuation shows a clear trend to return to baseline values. HOMA-IR is the only predictive factor of weight regain.

Original languageEnglish
Pages (from-to)163-169
Number of pages7
JournalCNS Drugs
Volume29
Issue number2
DOIs
Publication statusPublished - 2015

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Psychiatry and Mental health
  • Clinical Neurology
  • Medicine(all)

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    Verrotti, A., Parisi, P., Agostinelli, S., Loiacono, G., Marra, F., Coppola, G., Pisani, L. R., Gorgone, G., Striano, P., Pisani, F., & Belcastro, V. (2015). Weight regain after discontinuation of topiramate treatment in patients with migraine: A prospective observational study. CNS Drugs, 29(2), 163-169. https://doi.org/10.1007/s40263-015-0229-z