{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T04:37:03Z","timestamp":1790915823115,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2006,1,12]],"date-time":"2006-01-12T00:00:00Z","timestamp":1137024000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bipolar Disorders"],"published-print":{"date-parts":[[2006,2]]},"abstract":"<jats:p>\n                    <jats:bold>Objective:\u2002<\/jats:bold>\n                    To evaluate the efficacy and tolerability of topiramate monotherapy in adults with acute manic or mixed episodes of bipolar I disorder.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:\u2002<\/jats:bold>\n                    In four trials, adults hospitalized with acute mania, a diagnosis of bipolar I disorder, history of \u22651 previous manic or mixed episodes, and \u226520 Young Mania Rating Scale (YMRS) score were randomized to double\u2010blind treatment with topiramate (target doses: 200, 400, or 600\u2003mg\/day) or placebo; two trials included an active comparator (lithium, 1500\u2003mg\/day). The core study duration in all trials was 3\u2003weeks; three trials also had 9\u2010week double\u2010blind extensions. The primary efficacy variable was mean change from baseline in YMRS in the core 3\u2010week study.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:\u2002<\/jats:bold>\n                    Changes in YMRS score during 3\u2003weeks were not significantly different for topiramate versus placebo (mean YMRS reductions, \u22125.1 to \u22128.4). Mean YMRS reductions in lithium\u2010treated groups were significantly greater (p\u2003\u2264\u20030.001 versus placebo and topiramate). A similar pattern was observed after 12\u2003weeks of double\u2010blind treatment in studies with double\u2010blind extensions. Paresthesia, appetite decrease, dry mouth, and weight loss were more frequently associated with topiramate than with placebo.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusions:\u2002<\/jats:bold>\n                    These studies do not support the efficacy of topiramate as monotherapy in acute mania or mixed episodes in adults with bipolar I disorder. Topiramate was not associated with mood destabilization measured as mania exacerbation or treatment\u2010emergent depression. Lithium was confirmed as an effective therapy in this population.\n                  <\/jats:p>","DOI":"10.1111\/j.1399-5618.2006.00276.x","type":"journal-article","created":{"date-parts":[[2006,1,12]],"date-time":"2006-01-12T08:25:50Z","timestamp":1137054350000},"page":"15-27","source":"Crossref","is-referenced-by-count":163,"title":["Topiramate monotherapy in the management of acute mania: results of four double\u2010blind placebo\u2010controlled trials"],"prefix":"10.1111","volume":"8","author":[{"given":"Stuart F","family":"Kushner","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akbar","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosanne","family":"Lane","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William 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