Abstract
Objective: To report observations on the efficacy and tolerability of topiramate in a sample of five patients with severe symptoms of bulimia nervosa and comorbid mood and/or anxiety disorders.Method: Topiramate was added to other psychotropic medication under open‐label conditions up to the maximum tolerated dose or until remission of the eating disorder was achieved.Results: Topiramate almost completely eliminated binging and purging behavior in three of the five patients. Improvement was maintained throughout the period of follow‐up for up to 18 months. One patient showed a partial, temporary response, and the fifth was intolerant of the drug and unable to complete an adequate trial.Discussion: These results suggest strongly that the efficacy of topiramate in patients with bulimia nervosa with and without comorbid mood and anxiety disorders should be investigated more fully. © 2003 by Wiley Periodicals, Inc. Int J Eat Disord 33: 468–472, 2003.

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