A Rare, Unreported Cognitive Side Effect of Topiramate: Do We Know It All Yet?

Abstract

This report describes a unique, dose dependent side effect of a commonly used drug, topiramate. Although cognitive side effects of this drug have previously been reported in literature, we present a case of druginduced amnesia, with support from Naranjo Nomogram, as a hitherto unreported side effect of topiramate. Here, we highlight the importance of being cognizant of such rare cognitive side effects, with the aim of improving patient outcome by timely recognition, and discontinuation of the offending drug, as the side effect was fortunately found to be reversible.

Topiramate-Induced Suicidal Ideation and Olfactory Hallucinations: A Case Report

“…However, patient profiles that are more prone to CAE remain unclear and this should be further studied. A case report of a 25-yearold woman highlights an extreme case of cognitive impairment where she experienced dissociative amnesia at TPM 100 mg/day for migraine prophylaxis [19]. The explanation brought forward by the authors was that the action of TPM inhibits excitatory glutamate and enhances the inhibitory effects of the gamma-aminobutyric acid (GABA) system due to its impact on neurons' voltage-gated sodium and calcium channels [19].…”

“…A case report of a 25-yearold woman highlights an extreme case of cognitive impairment where she experienced dissociative amnesia at TPM 100 mg/day for migraine prophylaxis [19]. The explanation brought forward by the authors was that the action of TPM inhibits excitatory glutamate and enhances the inhibitory effects of the gamma-aminobutyric acid (GABA) system due to its impact on neurons' voltage-gated sodium and calcium channels [19]. Considering that TPM can take up two to four weeks to reach its full effect in the prevention of migraine and as an anticonvulsant, it is possible that the presented patient experienced his mild cognitive symptoms as a result of taking TPM [20].…”

Topamax® and Ginger Oil Potential Neurotoxicity And Their Interaction in Mice Thru Oxidative Stress and Inflammatory Markers, Neurotransmitters Expression and Immunohistochemical Measurements

“…Tiredness, paresthesia, drowsiness, loss of appetite, nausea, diarrhea, and a sour taste in the mouth are the most prevalent side effects associated with Topamax® use. Blurred vision [6], anxiety, or suicidal thoughts [7], hyperchloremic acidosis, hepatic-renal-toxicity, and negative consequences on cognition and memory have also been recorded (5,(8)(9)(10).…”