General Hospital Psychiatry
Volume 32, Issue 6 , Pages 647.e1-647.e3 , November 2010

Topiramate-induced confusion following a single ingestion of 400 mg

  • Matthew D. Pierson, M.D.

      Affiliations

    • Duke University Hospital, Durham, NC 27710, USA
    • ,
  • Andrew J. Muzyk, Pharm.D.

      Affiliations

    • Duke University Hospital, Durham, NC 27710, USA
    • Campbell University College of Pharmacy and Health Sciences, Durham, NC 27710, USA
    • Corresponding Author InformationCorresponding author. Duke University Hospital, Campbell University School of Pharmacy, P.O. Box 3089–Pharmacy, Durham, NC 27710, USA. Tel.: +1 919 681 3438 (office).
    • ,
  • Megan Lockamy, Pharm.D.

      Affiliations

    • Campbell University College of Pharmacy and Health Sciences, Durham, NC 27710, USA
    • ,
  • Xavier A. Preud'homme, M.D.

      Affiliations

    • Duke University Hospital, Durham, NC 27710, USA

Received 23 April 2010 ,Accepted 25 May 2010.

References 

  1. Fontebasso M. Topiramate for migraine prophylaxis. Expert Opin Pharmacother. 2007;8(16):2811–2823
  2. Naegel S, Oberman M. Topiramate in the prevention and treatment of migraine: efficacy, safety and patient preference. Neuropsychiatr Dis Treat. 2010;6:17–28
  3. Shank RP, Gardocki JF, Streeter AJ, Maryanoff BE. An overview of the preclinical aspects of topiramate: pharmacology, pharmacokinetics, and mechanism of action. Epilepsia. 2000;41(Suppl 1):S3–S9
  4. White HS, Brown SD, Woodhead JH, Skeen GA, Wolf HH. Topiramate enhances GABA-mediated chloride flux and GABA-evoked chloride currents in the murine brain neurons and increases seizure threshold. Epilepsy Res. 1997;28:167–179
  5. Taverna S, Sancini G, Mantegazza M, Franceschetti S, Avanzini G. Inhibition of transient and persistent Na+ current fractions by the new anticonvulsant topiramate. J Pharmacol Exp Ther. 1999;288:960–968
  6. Gibbs JW, Sombati S, DeLorenzo RJ, Coulter DA. Cellular actions of topiramate: blockade of kainite-evoked inward currents in cultured hippocampal neurons. Epilepsia. 2000;41(Suppl 1):S10–S16
  7. Fakhoury T, Murray L, Seger D, McLean M, Abou-Khalil B. Topiramate overdose: clinical and laboratory features. Epilepsy Behav. 2002;3:185–189
  8. Lofton A, Klein-Schwartz W. Evaluation of toxicity of topiramate exposures reported to poison centers. Hum Exp Toxicol. 2005;24:591–595
  9. Chung AM, Reed MD. Intention topiramate ingestion in an adolescent female. Ann Pharmacother. 2004;38:1439–1442
  10. Brar B, Glazer JP, Franco K, Edwards T. Acute mental status changes with topiramate. J Am Acad Chil Adolesc Psychiatry. 2005;44:8
  11. Package Insert . Topamax (topiramate) tablets and sprinkle capsules. Titusville (NJ): Ortho-McNeil-Janssen Pharmaceuticals, Inc.; 2009;
  12. Perruca E, Bialer M. The clinical pharmacokinetics of the newer antiepileptic drugs. Focus on topiramate, zonisamide, and tiagabine. Clin Pharmacokinet. 1996;31:29–46
  13. Smith AG, Brauer HR, Catalano G, Catalano MC. Topiramate overdose: a case report and literature review. Epilepsy and Behavior. 2001;2:603–607
  14. Brandt C, Elsner H, Furatsch N, et al. Topiramate overdose: a case report of a patient with extremely high topiramate serum concentrations and nonconvulsive status epilepticus. Epilepsia. 2009;[Epub ahead of print]
  15. Shiber JR. Severe non-anion gap metabolic acidosis induced by topiramate: a case report. J Emerg Med. 2009;[Epub ahead of print]
  16. Mirza N, Marson AG, Pirmohamed M. Effect of topiramate on acid–base balance: extent, mechanism and effects. Br J Clin Pharmacol. 2009;68(5):655–661

☆ Financial disclosure: The authors of this article did not receive any financial support for their work.

PII: S0163-8343(10)00105-2

doi: 10.1016/j.genhosppsych.2010.05.004

General Hospital Psychiatry
Volume 32, Issue 6 , Pages 647.e1-647.e3 , November 2010

Article Tools