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Various toxicities: case report An approximately 12-year-old girl developed weight gain during treatment with levetiracetam and phenobarbital. Additionally, she developed weight loss and self-injurious behaviour following abuse and overdose of topiramate [routes not stated]. The girl presented at the age of 16-years to the psychiatry department with complaints of self-injurious behavior and not accepting food for 20 days. She was pursuing class 11, but was irregular in attendance to the classes. She was excessively concerned about her body image and appearance. At the age of 12 years, she started experiencing complex partial seizures. Her weight was 43kg. She was initially started on unspecified antiepileptics; however, seizures were not controlled. Later, she was diagnosed with glioma in her right temporal lobe, which was removed by surgery. She was started on prophylactic antiepileptic therapy with phenobarbital [phenobarbitone] 120 mg/day and levetiracetam 1000 mg/day. Three months later, she reported weight gain of up to 5kg (measured 48kg). On rejoining school, she was teased by her schoolmates to be overweight. She felt upset and became irregular in attendance to school. She had an unstable relationship with a junior in school. She regularly complained about her increased weight and began to refuse food. She exercised excessively and drank only water to reduce her weight with a target to reduce it by at least 25kg. During internet browsing for weight reduction strategies, she found that weight gain could be a side effect of many antiepileptic drugs except topiramate, and topiramate could reduce weight. So, she herself changed her therapy to topiramate 100mg tablet and gradually increased the dose to 1000 mg/day (topiramate tablets 4-2-4; abuse and overdose). She told her parents to give the drug of her choice or else threatened to commit suicide. She attempted self-harm several times. Due to concerns of untoward consequences, her parents regularly gave her topiramate tablets. She continued to abuse topiramate, and gradually decreased intake of all solid foods, due to which she was finally admitted (current presentation). On the day of admission, her weight had reduced to 35kg, which was considered to be a side-effect of topiramate. She was then diagnosed to have underlying anorexia nervosa and an emerging borderline personality disorder. The girl needed a prophylactic antiepileptic; therefore, the dose of topiramate was slowly tapered down and brought to a safe therapeutic dose of 400 mg/day over a period of few weeks. For anorexia nervosa, she was treated with escitalopram. Nutritional rehabilitation and weight restoration strategies were also implemented, which helped her gain weight. Later, she started to accept diet as her anorexic symptoms had reduced. During her hospital stay, she gained 3kg weight. Her abnormal behaviour and suicidal threats were managed with cognitive behaviour therapy. Kakunje A, et al. Topiramate (1000 mg) Abuse for Weight Loss in an Adolescent with Anorexia Nervosa. Journal o