This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Lofton, A L Articles by Klein-Schwartz, W. Search for Related Content PubMed PubMed Citation Articles by Lofton, A L Articles by Klein-Schwartz, W. Social Bookmarking                   What's this?

Evaluation of toxicity of topiramate exposures reported to poison centers

Beverly Hospital, Northeast Health Systems, USA

Wendy Klein-Schwartz

Department of Pharmacy Practice and Science, Maryland Poison Center, University of Maryland School of Pharmacy, USA; 20 North Pine Street, Baltimore, MD 21201-1180, USAwkleinsc{at}rx.umaryland.edu

Published literature on the toxicity of a topiramate overdose is limited to case reports. This retrospective study of poison center data was performed to examine the severity of topiramate overdoses. Data on single substance exposures to topiramate reported to the American Association of Poison Control Centers (AAPCC) Toxic Exposure Surveillance System (TESS) in 2000 and 2001 were retrospectively analysed. A total of 567 cases met the inclusion criteria, of which 39% occurred in adults over 19 years of age and 30.2% in children 5 / 4 years old. The majority of patients (62.1%) experienced no toxicity. The most common clinical effects reported were drowsiness/lethargy (15.5%), dizziness/vertigo (4.9%), agitation (4.9%), confusion (3.9%), nausea (2.6%) and vomiting (2.5%). Symptomatic patients were older than asymptomatic patients and adults were more likely to be managed in a healthcare facility (P B / 0.0001). Patients who received gastrointestinal decontamination experienced less serious outcomes than those without decontamination (P B / 0.02). It is concluded that clinicians should expect relatively mild mental status changes in adults or children with toxicity from topiramate overdose. Serious toxic effects, such as CNS depression with respiratory depression or persistent non-anion gap metabolic acidosis, are infrequent.

Key Words: anticonvulsant • overdose • topiramate • toxicity

Human & Experimental Toxicology, Vol. 24, No. 11, 591-595 (2005)
DOI: 10.1191/0960327105ht561oa


CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?