SummaryBackground This study was initiated following a serendipitous finding in which a patient who presented with both a mood disorder and psoriasis experienced significant improvement of her psoriasis following treatment with topiramate.
Objectives To determine the efficacy of topiramate for the treatment of psoriasis.
Methods Seven other patients, six of whom presented with both mood disorders and psoriasis and one with psoriasis only, were treated in an open-label fashion with topiramate. Topiramate therapy was usually initiated at 15 mg day−1 and gradually titrated by 15 mg week−1 to an average final dose of 56 mg day−1. Patients were treated for a minimum of 4 months. Psoriasis severity was measured using the psoriasis area and severity index (PASI).
Results For all patients, the mean PASI score decreased from 16·1 before treatment to 7·1. For patients exhibiting improvement, the mean PASI score decreased from 14·3 to 3·9.
Conclusions These results represent the first known report of the efficacy of topiramate in the treatment of psoriasis.