Topiramate-Induced Somnambulism in a Migraineur: A Probable Idiosyncratic Adverse Effect

Mathew, Thomas; Sarma, G.R.K.; Nadig, Raghunandan; Varghese, Raji Mathew

doi:10.5664/jcsm.1782

Cited by 13 publications

(5 citation statements)

References 7 publications

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“…2 b) [ 72 , 73 ]. While there is some published evidence, the significant positive correlation between TPM use and the LAEP subdomains of headaches, skin problems, and disturbed sleep in the present analysis was clinically unapparent [ 74 – 78 ]. Unsteadiness and memory problems have also been described with ZNS use [ 79 ], which is in line with the results of the LAEP subdomain analysis (Fig.…”

Section: Discussioncontrasting

confidence: 73%

Adverse Event Profiles of Antiseizure Medications and the Impact of Coadministration on Drug Tolerability in Adults with Epilepsy

Willems,

van der Goten,

von Podewils

et al. 2023

CNS Drugs

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Background Antiseizure medication (ASM) as monotherapy or in combination is the treatment of choice for most patients with epilepsy. Therefore, knowledge about the typical adverse events (AEs) for ASMs and other coadministered drugs (CDs) is essential for practitioners and patients. Due to frequent polypharmacy, it is often difficult to clinically assess the AE profiles of ASMs and differentiate the influence of CDs. Objective This retrospective analysis aimed to determine typical AE profiles for ASMs and assess the impact of CDs on AEs in clinical practice. Methods The Liverpool AE Profile (LAEP) and its domains were used to identify the AE profiles of ASMs based on data from a large German multicenter study (Epi2020). Following established classifications, drugs were grouped according to their mode of action (ASMs) or clinical indication (CDs). Bivariate correlation, multivariate ordinal regression (MORA), and artificial neural network (ANNA) analyses were performed. Bivariate correlation with Fisher’s z -transformation was used to compare the correlation strength of LAEP with the Hospital Anxiety and Depression Scale (HADS) and Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) to avoid LAEP bias in the context of antidepressant therapy. Results Data from 486 patients were analyzed. The AE profiles of ASM categories and single ASMs matched those reported in the literature. Synaptic vesicle glycoprotein 2A (SV2A) and voltage-gated sodium channel (VGSC) modulators had favorable AE profiles, while brivaracetam was superior to levetiracetam regarding psychobehavioral AEs. MORA revealed that, in addition to seizure frequency, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) modulators and antidepressants were the only independent predictors of high LAEP values. After Fisher’s z -transformation, correlations were significantly lower between LAEP and antidepressants than between LAEP and HADS or NDDI-E. Therefore, a bias in the results toward over interpreting the impact of antidepressants on LAEP was presumed. In the ANNA, perampanel, zonisamide, topiramate, and valproic acid were important nodes in the network, while VGSC and SV2A modulators had low relevance for predicting relevant AEs. Similarly, cardiovascular agents, analgesics, and antipsychotics were important CDs in the ANNA model. Conclusion ASMs have characteristic AE profiles that are highly reproducible and must be considered in therapeutic decision-making. Therapy using perampanel as an AMPA modulator should be considered cautiously due to its relatively high AE profile. Drugs acting via VGSCs and SV2A receptors are significantly better tolerated than other ASM categories or substances (e.g., topiramate, zonisamide, and valproate). Switching to brivaracetam is advisable in patients with psychobehavioral AEs who take levetiracetam. Because CDs f...

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Section: Discussioncontrasting

confidence: 73%

Adverse Event Profiles of Antiseizure Medications and the Impact of Coadministration on Drug Tolerability in Adults with Epilepsy

Willems,

van der Goten,

von Podewils

et al. 2023

CNS Drugs

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“…It can also occur as a reaction to drugs, medications, and alcohol, as well as medical conditions such as seizures. Medications that have been reported to cause sleepwalking include neuroleptics, hypnotics, lithium, amitriptyline, topiramate and β-blockers 4 . The greatest risk for drug-induced somnambulism has been found to occur two to fourteen days after the initiation of treatment with a new medication, and somnambulism can be very transient or may last until the medication is discontinued 5 .…”

Section: Discussionmentioning

confidence: 99%

Somnambulism During Monotherapy With Mixed Amphetamine Salts

Pinnaka

Gosai

Czekierdowski

et al. 2016

Journal of Clinical Psychopharmacology

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“…Other medications associated with somnambulism include paroxetine, reboxetine, bupropion, topiramate, and some benzodiazepines, particularly triazolam and alprazolam (25–32). To our knowledge, no cases of complex amnestic behavior have been reported citing the serotonin reuptake inhibitor (SSRI) Citalopram, present in this case, as an inciting factor.…”

Section: Discussionmentioning

confidence: 99%

Amnestic Somnambulism and Nocturnal Eating Disorder Associated with Zolpidem Use as a Contributing Factor in Accidental Death

Stump

Presnell

2015

Academic Forensic Pathology

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Zolpidem is a selective gamma-aminobutyric acid (GABA) receptor modulator used commonly in the treatment of insomnia. It is effective at initiating sleep and has primary effects similar to benzodiazepines. Zolpidem has gained some notoriety for its association with rare but unusual side effects of compulsive nocturnal activity with anterograde amnesia. Review of the literature documents zolpidem-associated nocturnal activities, which include walking, eating, and more complex activities such as house cleaning or driving. During these events, the sleeper may be able to converse and initially appear normal to an observer, but has limited, if any, recollection of the event. Other literature reviewing zolpidem-related deaths, hospital admissions, falls, and somnambulism found a high rate of concurrent alcohol and/or other drug use than when using Zolpidem alone. We present a case of a 67-year-old woman with a history of somnambulism and amnestic eating during the night after using Zolpidem who was found deceased on the pavement below her opened second story bedroom window. Autopsy revealed nonocclusive food substances in her airways, and head and neck trauma, consistent with a fall from the second story window. Toxicological analysis of peripheral blood revealed Zolpidem (69 ng/mL), pseudoephedrine (150 ng/mL), citalopram/escitalopram (400 ng/mL), and caffeine. Blood and vitreous ethanol concentrations were 194 mg/dL and 160 mg/dL, respectively. Given the decedent's nocturnal activity history associated with Zolpidem, Zolpidem use combined with ethanol was considered contributory to her death.

show abstract

Topiramate-Induced Somnambulism in a Migraineur: A Probable Idiosyncratic Adverse Effect

Cited by 13 publications

References 7 publications

Adverse Event Profiles of Antiseizure Medications and the Impact of Coadministration on Drug Tolerability in Adults with Epilepsy

Adverse Event Profiles of Antiseizure Medications and the Impact of Coadministration on Drug Tolerability in Adults with Epilepsy

Somnambulism During Monotherapy With Mixed Amphetamine Salts

Amnestic Somnambulism and Nocturnal Eating Disorder Associated with Zolpidem Use as a Contributing Factor in Accidental Death

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