Authors: Binder C, et al. 
Title: An open-label trial of topiramate adjunct in bipolar patients with mood instability.
Reference: European Neuropsychopharmacology. The Journal of the European College of Neuropsychopharmacology 2003;13(Suppl ):S329. [Congress abstract]
Purpose: To determine the safety, optimal dosing, and effectiveness of topiramate add-on treatment in bipolar patients with mood instability.  
Study design: Open-label, multicenter trial. 
Follow up: 16 weeks. 
Patients: 109 patients.
Treatment: Topiramate titrated to a maximum of 400 mg/day. 
Results: Topiramate was associated with a significant reduction in mania scores from week 2 to the endpoint. Adverse events included headache, nausea, diarrhea, and fatigue. A significant weight loss in patients was observed.