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Topiramate-induced delusional parasitosis.
1Neurology Department, Royal Adelaide Hospital, North Terrace, Adelaide, South Australia 5000, Australia.
Summary
Topiramate (TPM), an epilepsy medication, can rarely cause delusional parasitosis (DP), a condition where patients believe they are infested with parasites. This case highlights the importance of considering drug-induced psychosis in epilepsy patients.
Area of Science:
- Neurology
- Psychiatry
- Pharmacology
Background:
- Topiramate (TPM) is an anticonvulsant medication commonly used for epilepsy management.
- Psychiatric side effects of TPM are recognized, but drug-induced delusional parasitosis (DP) is rare.
Observation:
- A 48-year-old woman with epilepsy developed intense pruritus and a delusion of parasitic skin infestation after starting TPM.
- Her symptoms of delusional parasitosis resolved completely after discontinuing TPM, without antipsychotic treatment.
Findings:
- This case presents the first documented instance of topiramate-induced delusional parasitosis.
- The findings suggest a potential link between TPM and the development of DP in susceptible individuals.
Implications:
- Clinicians should consider DP as a potential adverse effect of topiramate, especially in epilepsy patients.
- Discontinuation of the offending drug may be sufficient for resolving TPM-induced DP, avoiding the need for antipsychotics.
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