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Microdialysis of Excitatory Amino Acids During EEG Recordings in Freely Moving Rats
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Topiramate-Related Hyperammonemia.

Kelly Moore1, Deepali Dixit2,3, Mary Wagner2,3

  • 1Hospital of Special Surgery, New York, NY, USA.

The Journal of Pharmacy Technology : Jpt : Official Publication of the Association of Pharmacy Technicians
|December 3, 2021
PubMed
Summary
This summary is machine-generated.

This case highlights topiramate-related hyperammonemia, a serious condition exacerbated by valproic acid. Discontinuing topiramate and tapering valproic acid normalized ammonia levels, confirming a drug interaction.

Keywords:
adverse reactiondrug interactionhyperammonemiatopiramatevalproic acid

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Area of Science:

  • Neurology
  • Clinical Pharmacology

Background:

  • Valproic acid is known to cause hyperammonemic encephalopathy.
  • The interaction between topiramate and valproic acid leading to hyperammonemia is documented but requires further investigation.

Purpose of the Study:

  • To report a case of hyperammonemia resulting from the interaction between topiramate and valproic acid.
  • To emphasize the pharmacodynamic interaction between these two drugs.

Main Methods:

  • A patient case report detailing the onset and resolution of hyperammonemia.
  • Monitoring of ammonia levels following administration and discontinuation/tapering of topiramate and valproic acid.

Main Results:

  • The patient developed hyperammonemia after receiving valproic acid while already on topiramate.
  • Elevated ammonia levels worsened with increased valproic acid dosing frequency.
  • Ammonia levels normalized upon discontinuation of topiramate and tapering of valproic acid.

Conclusions:

  • This case supports the association of topiramate with hyperammonemia.
  • The co-administration of valproic acid can pharmacodynamically interact with topiramate, leading to hyperammonemia.