Topiramate
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Topiramate
Dementia (first report) in an elderly patient: case report A 77-year-old woman developed reversible dementia while receiving topiramate for a depressive disorder. After initiation, the woman’s topiramate dose was titrated up to 200 mg/day over 6 weeks. She also received concomitant sertraline. Subsequently, she gradually experienced forgetfulness, and had difficulties with language and daily activities like shopping [time to reaction onset not stated]. She presented for evaluation after 3 months’ treatment, and was found to be disoriented in time, and having difficulty recalling items after 5 minutes. She also displayed difficulty in naming objects, and scored low on the Semantic Verbal Fluency Test. She recorded a score of 18 on the Mini Mental State Examination (MMSE), and was diagnosed with dementia. All other investigations were normal, including a brain MRI. Topiramate was discontinued. One week later the woman’s family noticed improvement in her language and in her ability to go shopping. One month later she scored 29 on the MMSE. Author comment: "Functional magnetic resonance imaging reveals that topiramate has a critical effect on the cerebral neural systems that mediate expressive language." Sempere AP, et al. Reversible dementia secondary to topiramate. Clinical Neuropharmacology 31: 62, No. 1, Jan-Feb 2008 - Spain
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» Editorial comment: A search of AdisBase, Medline and Embase did not reveal any previous case reports of dementia associated with topiramate. The WHO Adverse Drug Reactions database contained five reports of dementia associated with topiramate.
0114-9954/10/1189-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 16 Feb 2008 No. 1189
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