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Confusion and dysphoria with low‐dose topiramate in a patient with bipolar disorder
Author(s) -
Andrade Chittaranjan
Publication year - 2001
Publication title -
bipolar disorders
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.285
H-Index - 129
eISSN - 1399-5618
pISSN - 1398-5647
DOI - 10.1034/j.1399-5618.2001.30406.x
Subject(s) - topiramate , discontinuation , confusion , dysphoria , mania , adverse effect , bipolar disorder , psychiatry , medicine , hypomania , psychology , pediatrics , anesthesia , epilepsy , mood , anxiety , psychoanalysis
Background:Topiramate, a newer antiepileptic agent, may benefit several neurological and psychiatric states, including bipolar disorder.
Case report: A physically healthy, stockily built, 47‐year‐old, hypomanic Asian male with a >20‐year history of uneventful use of psychotropic agents received topiramate in a dose that was stepped up to 100 mg/day across 10 days. He developed dysphoria, confusion, word‐finding difficulties, and difficulties in maintaining a train of thought; the symptoms vanished within a week of drug discontinuation, and reappeared 1–2 days after rechallenge at a dose of 25 mg/day.
Conclusion: It appears that, while confusion is usually a dose‐dependent adverse effect of topiramate, certain patients may idiosyncratically develop this adverse effect at very low doses.