Topiramate-associated urinary incontinence: a case verified by rechallenge

Topiramate is an anticonvulsant that has been widely used in psychiatric conditions. The most common treatment-related adverse effects of topiramate were diarrhea, nausea, loss of appetite, fatigue, paresthesia, cognitive impairment, and metabolic acidosis. The following is a case report intended to draw attention to a rarely reported adverse effect of topiramate. A male patient treated with topiramate developed urinary incontinence that was considered drug associated because of the temporal relationship between its appearance and the commencement of topiramate, its resolution upon topiramate discontinuation, and its recurrence with topiramate rechallenge. Urinary incontinence, although not life threatening, can be a distressing problem with a profound impact on quality of life. This case reminds that physicians prescribing topiramate should be aware of this possible adverse effect and communicate it to patients and their caregivers.