Exp Clin Endocrinol Diabetes 2010; 118(7): 449-452
DOI: 10.1055/s-0030-1248289
Article

© J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart · New York

Weight Reducing and Metabolic Effects of Topiramate in Patients with Migraine – an Observational Study

M. Schütt1 , J. Brinkhoff2 [*] , M. Drenckhan1 , H. Lehnert1 , C. Sommer2
  • 1Department of Internal Medicine I, University of Lübeck, Lübeck, Germany
  • 2Department of Neurology, University of Würzburg, Würzburg, Germany
Further Information

Publication History

received 23.12.2009 first decision 20.01.2010

accepted 22.01.2010

Publication Date:
03 March 2010 (eFirst)

Abstract

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/m2) 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)-α. 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-α 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.

References

1 present address: Department of Neurology and Clinical Neurophysiology, Academic Hospital Bogenhausen, Technical University of Munich, Germany.*

Correspondence

PD Dr. med. M. Schütt

Department of Internal Medicine I

University of Lübeck

D-23538

Lübeck

Phone: 49/451/500 5971

Fax: 49/451/500 4807

Email: morten.schuett@uk-sh.de