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Objective: To evaluate the efficacy and tolerability of topiramate in patients with posttraumatic stress disorder (PTSD). Method: We conducted a 12‐week double‐blind, randomized, placebo‐controlled study comparing topiramate to placebo. Men and women aged 18–62 years with diagnosis of PTSD according to DSM‐IV were recruited from the outpatient clinic of the violence program of Federal University of São Paulo Hospital (Prove‐UNIFESP), São Paulo City, between April 2006 and December 2009. Subjects were assessed for the Clinician‐Administered Posttraumatic Stress Scale (CAPS), Clinical Global Impression, and Beck Depression Inventory (BDI). After 1‐week period of washout, 35 patients were randomized to either group. The primary outcome measure was the CAPS total score changes from baseline to the endpoint. Results: 82.35% of patients in the topiramate group exhibited improvements in …