title: Randomized clinical trial of topiramate for levodopa-induced dyskinesia in Parkinson's disease.
abstract: BACKGROUND
  The antiepileptic drug topiramate reduces levodopa-induced dyskinesia without exacerbating parkinsonism in animal models. We report a randomized, double-blind, placebo-controlled crossover trial in patients with Parkinson's disease and levodopa-induced dyskinesia.
  
  
  METHODS
  Fifteen patients with Parkinson's disease and stable levodopa-induced dyskinesia were enrolled into the study, of whom 13 were randomized to topiramate or placebo. The study medication was titrated to 100 mg/day over four weeks, and assessments were carried out after a further two weeks. Dyskinesia severity assessed by a blinded rater from video recordings was the primary outcome measure.
  
  
  RESULTS
  Seven patients (mean age 58.9 ± 12.8 years) completed the study. Patients taking topiramate vs. placebo showed a significant increase in dyskinesia severity compared to baseline (Wilcoxon signed rank test, P = 0.043). Five patients withdrew from the study whilst taking topiramate due to adverse effects.
  
  
  CONCLUSIONS
  Topiramate tended to worsen dyskinesia in patients with Parkinson's disease, and was poorly tolerated.
authors: Centre for Clinical and Cognitive Neurosciences, Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK; Department of Neurology, Greater Manchester Neurosciences Centre, Salford Royal NHS Foundation Trust, Salford, UK. Electronic address: christopher.kobylecki@manchester.ac.uk.
authors: Christopher
authors: C
authors: Kobylecki
authors: Institute for Ageing and Health, Newcastle University, Newcastle, UK.
authors: David J
authors: DJ
authors: Burn
authors: Centre for Clinical and Cognitive Neurosciences, Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK; Department of Neurology, Greater Manchester Neurosciences Centre, Salford Royal NHS Foundation Trust, Salford, UK.
authors: Lewis
authors: L
authors: Kass-Iliyya
authors: Department of Neurology, Greater Manchester Neurosciences Centre, Salford Royal NHS Foundation Trust, Salford, UK.
authors: Mark W
authors: MW
authors: Kellett
authors: Faculty of Life Sciences, University of Manchester, Manchester, UK.
authors: Alan R
authors: AR
authors: Crossman
authors: Centre for Clinical and Cognitive Neurosciences, Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK; Department of Neurology, Greater Manchester Neurosciences Centre, Salford Royal NHS Foundation Trust, Salford, UK.
authors: Monty A
authors: MA
authors: Silverdale
mesh_terms: D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000627:therapeutic use*; D000978:Antiparkinson Agents / Q000009:adverse effects; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004409:Dyskinesia, Drug-Induced / Q000188:drug therapy*; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D007980:Levodopa / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy*; D000077236:Topiramate
chemical_list: D000927:Anticonvulsants; D000978:Antiparkinson Agents; D000077236:Topiramate; D005632:Fructose; D007980:Levodopa
keywords: Clinical trial; Levodopa-induced dyskinesia; Parkinson's disease; Topiramate