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Topiramate Enhances the Risk of Valproate‐associated Side Effects in Three Children
Author(s) -
Longin Elke,
Teich Martin,
Koelfen W.,
König Stefan
Publication year - 2002
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1046/j.1528-1157.2002.42401.x
Subject(s) - topiramate , discontinuation , side effect (computer science) , adverse effect , medicine , epilepsy , apathy , refractory (planetary science) , valproic acid , pediatrics , anesthesia , psychiatry , disease , physics , astrobiology , computer science , programming language
Summary: Purpose: We present three children with severe therapy‐refractory epilepsy who tolerated valproate (VPA) well in various combinations with other antiepileptic drugs (AEDs) but developed typical VPA side effects in combination with topiramate (TPM). Methods: The clinical symptoms began with apathy in all three children; two of them also had hypothermia. Furthermore all children had elevated blood ammonia levels, one child in combination with increased liver transaminases and one with thrombocytopenia. Results: All children recovered completely after discontinuation of VPA or TPM. Conclusions: TPM seems likely to enhance the risk of side effects usually attributed to VPA and not described in TPM monotherapy. Our case reports suggest that possible adverse effects of VPA should be given particular attention when VPA is combined with TPM.