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Letter
Topiramate induced manic episode
  1. T Jochum,
  2. K J Bär,
  3. H Sauer
  1. Department of Psychiatry, Friedrich-Schiller University of Jena, Philosophenweg 3, 07743 Jena, Germany
  1. Correspondence to:
 Dr K J Bär, Klinik für Psychiatrie, Philosophenweg 3, 07743 Jena, Germany;
 Karl-Juergen.Baer{at}med.uni-jena.de

https://doi.org/10.1136/jnnp.73.2.208

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    Topiramate is a novel antiepileptic drug (AED) that has been in use for several years, mainly as add on treatment for partial and secondarily generalising seizures that are otherwise refractory to treatment.1 Despite the good efficacy of topiramate, dizziness, ataxia, double vision, and somnolence have been noted as the main side effects. While older AEDs such as carbamazepine and sodium valproate are now routinely used for the treatment of mood disorders, recent studies suggest that novel AEDs, such as lamotrigine, gabapentin, tiagabine, and topiramate, have mood stabilising efficacy as well.2 Exacerbation of psychotic symptoms has been reported but mostly in patients with pre-existing psychiatric disorders.3,4 However, more patients than previously assumed may be affected by a broader range of side effects. We present a case of a patient taking topiramate who presented with an acute manic episode, lacking any previous history of affective disorders or episodes.

    A 57 year old woman with a history of temporal lobe epilepsy was referred to our hospital by her local general practitioner due to suicidal ideation …

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    Footnotes

    • Competing interests: none declared