Epilepsy drug treats sleep-related eating disorder

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Topamax, usually prescribed to prevent epileptic seizures, is also an effective treatment for so-called sleep-related eating disorder, according to a new study.

Sleep-related eating disorder, or SRED, “is a behavioral disorder combining the repetitive nocturnal awakenings of a sleep disorder with the driven, compulsive eating of a daytime eating disorder,” study author Dr. John W. Winkelman, of Harvard Medical School, Boston, writes in the Journal of Clinical Psychiatry.

The disorder “is characterized by partial or full awakenings from sleep with compulsive eating, usually of high-calorie foods.”

Winkelman reviewed the cases of 30 patients with SRED who were treated with Topamax (known generically as topiramate) in a sleeping disorders clinic.

Of the participants, 25 had at least one follow-up appointment. The average age of these 25 patients was 44 years, and three-quarters were female.

SRED had started when the subjects were an average of 25 years old. Before starting topiramate, all the patients experienced nocturnal eating on a nightly basis, and most had multiple episodes of eating per night.

After about 11 months of treatment, “17 (68%) of 25 patients were considered responders, 7 (28%) of 25 were unchanged, and 1 (4%) of 25 was worse,” Dr. Winkelman reports.

In addition, “Twenty-eight percent (7/25) of patients lost greater than 10% of body weight.”

Twenty-one patients reported some side effects, such as numbness or tingling, excessive daytime sleepiness, and sexual dysfunction.

“Topiramate was found to be of substantial benefit in patients with SRED ... though adverse events limited its tolerability,” Winkelman concludes. “Given the paucity of effective medication treatments for SRED, a controlled trial of topiramate in a larger sample of patients is indicated.”

SOURCE: Journal of Clinical Psychiatry, November 2006.

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