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[Psychosis with topiramate]
I García Cabeza1, M Gutiérrez Rodríguez, M M Epifanio Gutiérrez
1Hospital Psiquiátrico Provincial de Madrid.
Actas Espanolas De Psiquiatria
|September 23, 2000
Summary
Topiramate, an antiepileptic drug, may trigger schizophreniform disorder due to its GABAergic action. This psychiatric side effect is linked to potential overactivity in dopaminergic systems.
Area of Science:
- Neuroscience
- Pharmacology
- Psychiatry
Background:
- Topiramate is an antiepileptic drug effective for partial seizures, acting on sodium channels, GABA, and glutamatergic receptors.
- While generally safe, antiepileptic drugs can cause psychiatric side effects.
Observation:
- A case study details a woman who developed a schizophreniform disorder after initiating topiramate treatment.
- She experienced a similar disorder previously when treated with vigabatrin, another antiepileptic drug.
Findings:
- The gabaergic mechanism of topiramate is implicated as the primary cause of the psychotic episode.
- This is hypothesized to involve inhibition in the substantia nigra, leading to overactive ascending dopaminergic pathways.
Implications:
- This case highlights the potential for topiramate to induce psychiatric disturbances, specifically schizophreniform disorder.
- Understanding the neurobiological link between GABAergic modulation and dopaminergic systems is crucial for managing antiepileptic drug-induced psychosis.