[Psychosis with topiramate]

Topiramate is a new antiepileptic drug which acts in the sodium channels, GABA and glutamatergic receptors. It is an efficient treatment in epilepsy and has been approved as co-therapy for partial seizures. Topiramate has a safe profile of side effects, however, as any other antiepileptic drug, could produce psychiatric side effects. We present the case of a woman who develops a schizophreniform disorder after topiramate treatment. Before this one, she also had a very similar disorder when she was treated with vigabatrin. The gabaergic action of topiramate is proposed as the principal reason for the psychotic crisis, in relation to an inhibition in the substantia nigra which could produce an overactivity in ascending dopaminergic systems.