title: Reversible tremor and myoclonus associated with topiramate-fluvoxamine coadministration.
abstract: The antiepileptic agent topiramate has proved its efficacy in a variety of other conditions as well, including several kinds of tremor and migraine prophylaxis. We report on the case of a 42-year-old depressive female patient with comorbid migraine attacks, whereby the adjunction of topiramate as an antimigraine agent at the dosage of 50 mg/d to her antidepressive treatment with fluvoxamine at 300 mg/d triggered--the prima facie paradoxical for topiramate--side effects of tremor and myoclonus. Topiramate was immediately discontinued, and patient's abnormal movements subsided completely within 24 to 72 hours. Topiramate was possibly the cause of patient's abnormal movements enhanced by fluvoxamine's potential to induce also tremor and myoclonus. Therefore, clinicians should be aware of the potentially severe adverse reactions that might occur during concomitant treatment with fluvoxamine and topiramate.
authors.affiliation: Department of Psychiatry, Athens University Medical School, Eginition Hospital, Athens, Greece. oulisp@med.uoa.gr
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Oulis
authors.forename: Constantin
authors.initials: C
authors.lastname: Potagas
authors.forename: Vasilios G
authors.initials: VG
authors.lastname: Masdrakis
authors.forename: Yiannis
authors.initials: Y
authors.lastname: Thomopoulos
authors.forename: Anastasios V
authors.initials: AV
authors.lastname: Kouzoupis
authors.forename: Constantin R
authors.initials: CR
authors.lastname: Soldatos
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects*; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects*; D004338:Drug Combinations; D005260:Female; D016666:Fluvoxamine / Q000009:adverse effects*; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives*; D006801:Humans; D009207:Myoclonus / Q000139:chemically induced* / Q000503:physiopathology; D000077236:Topiramate; D014202:Tremor / Q000139:chemically induced* / Q000503:physiopathology; D028761:Withholding Treatment
chemical_list: D000927:Anticonvulsants; D018687:Antidepressive Agents, Second-Generation; D004338:Drug Combinations; D000077236:Topiramate; D005632:Fructose; D016666:Fluvoxamine