Topiramate in benzodiazepine withdrawal

There is an increasing interest in anticonvulsants for the treatment of benzodiazepine withdrawal symptoms. The new anticonvulsant compound topiramate seems to be an especially promising drug for this indication. It acts, among others, as an AMPA antagonist, which may be responsible in part for its anticonvulsant efficacy, but may also modulate the withdrawal-induced activation of noradrenergic neurons in the locus coeruleus, which are related to some behavioural effects of benzodiazepine withdrawal. A case is presented of a rapid benzodiazepine-withdrawal treated successfully with topiramate.