title: Acute mental status changes and hyperchloremic metabolic acidosis with long-term topiramate therapy.
abstract: Mental status changes and metabolic acidosis may occur with topiramate therapy. These adverse events were reported during dosage titration and with high dosages of the drug. A 20-year-old man receiving topiramate, valproic acid, and phenytoin experienced acute-onset mental status changes with hyperchloremic metabolic acidosis. He had been receiving a modest dose of topiramate for 9 months. He was weaned off topiramate over 5 days, and his mental status returned to baseline within 48 hours of discontinuing the agent. This case illustrates the need for close evaluation of patients who experience acute-onset mental status changes during topiramate therapy.
authors.affiliation: Department of Pharmacy Practice, College of Pharmacy, University of Arkansas for Medical Sciences, and the Arkansas Children's Hospital, Little Rock 72205-7122, USA.
authors.forename: C D
authors.initials: CD
authors.lastname: Stowe
authors.forename: T
authors.initials: T
authors.lastname: Bollinger
authors.forename: L P
authors.initials: LP
authors.lastname: James
authors.forename: T M
authors.initials: TM
authors.lastname: Haley
authors.forename: M L
authors.initials: ML
authors.lastname: Griebel
authors.forename: H C
authors.initials: HC
authors.lastname: Farrar
mesh_terms: D000138:Acidosis / Q000139:chemically induced*; D000208:Acute Disease; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects*; D002712:Chlorides / Q000097:blood; D003221:Confusion / Q000139:chemically induced*; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D012640:Seizures / Q000188:drug therapy; D000077236:Topiramate
chemical_list: D000927:Anticonvulsants; D002712:Chlorides; D000077236:Topiramate; D005632:Fructose