Topiramate for Co-Occurring Bipolar Disorder and Disruptive Behavior Disorders

This case study explored the use of topiramate in treating co-occurring bipolar disorder and disruptive behavior disorders in children and adolescents. Out of 9 hospitalized patients aged 10 to 14, 6 (67%) responded positively to adjunctive topiramate, with a mean dose of 78 mg/day. The study highlighted the case of a 14-year-old girl with conduct disorder and bipolar disorder, who showed significant improvement in disruptive behaviors and overall illness after topiramate treatment, despite some remaining emotional lability and distractibility. The study suggested that topiramate might be effective in treating disruptive behavior disorders independently of its effects on mania, potentially due to its impact on impulsivity. The favorable side effect profile, including possible weight loss, could enhance medication compliance. The authors recommended further randomized controlled studies to evaluate topiramate's efficacy, particularly in relation to aggression.