title: Acute topiramate overdose--clinical manifestations.
abstract: BACKGROUND
  The clinical manifestations of acute topiramate toxicity are described.
  
  
  METHODS
  Seven cases of acute and acute-on-chronic topiramate toxicity observed in two clinical units of Polish Poison Control Centers in 2004-2005 were analyzed.
  
  
  RESULTS
  The patients were 4 women and 2 men aged between 16 and 38 (mean 21.0 +/- 8.4) years. The doses of topiramate ranged from 10.7 to 218 mg/kg. The most frequent symptom was somnolence (66.7%) and, vertigo, agitation, and mydriasis were less common (33.4%). One patient who was not previously treated with topiramate experienced three secondarily generalized tonic-clonic seizures. Metabolic acidosis, lasting for 3-7 days, was observed in four cases, and did not influence the outcome.
  
  
  CONCLUSIONS
  The clinical manifestations of acute poisonings with topiramate ranged from asymptomatic to severe, but no distant sequelae or fatalities were observed. The course of acute poisoning seems to be more severe in patients who were not previously treated with topiramate.
authors.affiliation: Clinic of Internal Diseases and Acute Poisonings, Medical University of Gdańsk, Gdańsk, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Wiśniewski
authors.forename: Magdalena
authors.initials: M
authors.lastname: Łukasik-Głebocka
authors.forename: Jacek Sein
authors.initials: JS
authors.lastname: Anand
mesh_terms: D000138:Acidosis / Q000139:chemically induced; D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000506:poisoning*; D062787:Drug Overdose; D004830:Epilepsy, Tonic-Clonic / Q000139:chemically induced; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000506:poisoning; D006801:Humans; D008297:Male; D011039:Poison Control Centers / Q000706:statistics & numerical data; D011044:Poland / Q000453:epidemiology; D012720:Severity of Illness Index; D012894:Sleep Stages / Q000187:drug effects; D013406:Suicide, Attempted; D000077236:Topiramate; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose