Psychiatry Investig Search


Psychiatry Investigation 2006;3(2):73-80.
Six-week Open-label Trial of Topiramate to Treat Disruptive Behaviors in Children and Adolescents with or without Mental Retardation
Won Cheol Shin, MD1,2;Dong Ho Song, MD, PhD1,2;Eun Hye Ha, PhD3; and Yee Jin Shin, MD, PhD1,2;
1;Department of Psychiatry, Yonsei University College of Medicine, Seoul, 2;The Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, 3;Department of Child Welfare, Sookmyung Women's University, Seoul, Korea
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Anticonvulsants are known to be effective to manage affective instability and aggressive behavior by reducing neuronal excitability. This study examined the efficacy and safety of topiramate, a novel anticonvulsant, on disruptive behavioral problems in children and adolescents, with or without mental retardation (MR), and the differences of short-term efficacy and safety according to the IQ levels.

and Materials:

Fifty-four children and adolescents with disruptive behavioral problems were enrolled in a 6- week, open-label study. All subjects were divided into 3 groups (subjects without MR, Non-MR; subjects with mild MR, Mild MR; and subjects with moderate to severe MR, Mod-Severe MR) based on their intellectual ability, and treated with topiramate. Outcome measures included the Aberrant Behavior Checklist Hyperactivity (ABC-H) and Irritability (ABC-I) subscales and the Clinical Global Impression Severity (CGI-S) scale.


Significant reduction of CGI- S, ABC-H, and ABC-I scores were noted in all three groups in the following order: Non-MR, Mild MR, and Mod-Severe MR. Parethesia, anorexia, somnolence, nocturnal enuresis, and urinary frequency were relatively common adverse event. However, no serious adverse events were reported.


Topiramate was effective and well tolerated for managing disruptive behavioral problems and emotional instability in children and adolescents.

Key words   Topiramate;Youth;Disruptive behavior;Mental retardation.
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