Topiramate and weight loss in patients with neurodevelopmental disabilities

Study Objective. To characterize weight changes in patients with neurodevelopmental disabilities who received topiramate. Design. Retrospective, observational study. Setting. State-supported developmental center. Patients. Fifteen patients with neurodevelopmental disabilities who received topiramate therapy. Measurements and Main Results. Monthly weights for I year after the start of topiramate therapy were recorded. Mean body weight at drug initiation differed significantly compared with the nadir weight during the next 12 months (52.2 +/- 7.5 vs 49.9 +/- 7.2 kg, p<0.02). Twelve patients who were receiving ad libitum oral diets demonstrated a significant decrease in body weight (52.1 +/- 7.5 vs 49.0 +/- 7.3 kg, p<0.01), whereas the three patients who received enteral nutrition through enterostomy did not experience significant weight loss. Conclusion. Weight loss is common in patients with neurodevelopmental disabilities who receive topiramate. Since patients who received oral diets lost weight whereas those receiving enteral nutrition did not, decreased nutrient intake is the likely cause of weight loss.