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A fatal intoxication case involving topiramate
Beate Beer1, Kathrin Libiseller, Herbert Oberacher
1Institute of Legal Medicine, Innsbruck Medical University, Muellerstrasse 44, A-6020 Innsbruck, Austria. beate.beer@i-med.ac.at
Forensic Science International
|May 25, 2010
Summary
This case report details a fatal topiramate intoxication. High levels of topiramate, combined with citalopram, were found in a deceased patient, indicating a drug overdose as the cause of death.
Area of Science:
- Pharmacology
- Toxicology
- Neurology
Background:
- Topiramate is an anticonvulsant used for epilepsy and migraine prevention.
- Its complex pharmacology and neurostabilizing mechanisms are not fully understood.
- This report examines a fatal intoxication case involving topiramate.
Observation:
- A 41-year-old woman with psychiatric history was found unresponsive.
- Autopsy revealed signs of acute intoxication and shock.
- Drug packages of topiramate, citalopram, and flunitrazepam were present.
Findings:
- Toxicological analysis detected topiramate at 49mg/L in femoral blood, exceeding therapeutic levels.
- Citalopram (0.85mg/L) and trace flunitrazepam (<2μg/L) were also identified.
- The cause of death was attributed to combined topiramate and citalopram intoxication.
Implications:
- This case highlights the potential for fatal overdose with topiramate, even at prescribed doses.
- Concurrent use of other psychoactive medications may increase toxicity risks.
- Further research into topiramate's pharmacodynamics and overdose potential is warranted.
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