Hyperventilation and Cerebrospinal Fluid Acidosis Caused by Topiramate

Montcriol, Ambroise; Meaudre, Éric; Kenane, N.; Asencio, Y.; Bordes, Julien; Palmier, B.

doi:10.1345/aph.1k508

Cited by 11 publications

(4 citation statements)

References 15 publications

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“…publications found with both search terms). A total of 72 of them were reviewed in detail, and 47 articles published between 1996 and 2013 were retained for the final analysis, following inclusion of reports found in references (41 in English , five in Spanish and one in German ). They had been reported from following countries: USA ( n = 17), Spain ( n = 5), Great Britain ( n = 4), France ( n = 3), Italy ( n = 3), Brazil ( n = 2), Switzerland ( n = 2), Turkey ( n = 2), Argentina ( n = 1), Australia ( n = 1), Belgium ( n = 1), China ( n = 1), Germany ( n = 1), Hong Kong ( n = 1), Mexico ( n = 1), The Netherlands ( n = 1) and Saudi Arabia ( n = 1).…”

Section: Resultsmentioning

confidence: 99%

“…Symptoms likely to be related to metabolic acidosis were noted in two (1.3%) of the patients included in case–control studies and in 28 (22%) of those included in longitudinal studies. Symptoms of acidosis were also reported in 10 patients included in anecdotal reports containing two or fewer cases . The reported symptoms included deep and laboured breathing with increased frequency (in one case associated with chest pain), nausea with or without vomiting and central nervous system disturbances, such as lethargy or irritability and hallucinations.…”

Section: Resultsmentioning

confidence: 99%

“…In these subjects, circulating bicarbonate ranged from 12.0 to 20.0 mmol l −1 . In 14 case reports , acidosis was associated with a tendency towards hyperchloraemia (level ranging between 111 and 120 mmol l −1 ).…”

Section: Resultsmentioning

confidence: 99%

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Metabolic disturbances and renal stone promotion on treatment with topiramate: a systematic review

Dell’Orto

Belotti

Goeggel-Simonetti

et al. 2014

Br J Clin Pharmacol

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AIMSThe use of topiramate, which is prescribed for the management of epilepsy, for migraine headache prophylaxis and as a weight-loss agent, has been associated with the development of metabolic acidosis, hypokalaemia and renal stone disease. We systematically reviewed all the literature. METHODSThe systematic review of the literature was realized using the principles underlying the UK Economic and Social Research Council guidance on the conduct of narrative synthesis and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. RESULTSFourty-seven reports published between 1996 and 2013 were retained for the final analysis. Five case-control studies and six longitudinal studies addressed the effect of topiramate on acid-base and potassium balance. A significant tendency towards mild-to-moderate hyperchloraemic metabolic acidosis (with bicarbonate ≤21.0 mmol l −1 in approximately every third case) and mild hypokalaemia (with potassium ≤3.5 mmol l −1 in 10% of the cases) was noted on treatment with topiramate, which was similar in children and adults. A single study observed that topiramate causes mild hyperuricaemia in male adults. A tendency towards hypocitraturia, a recognized promoter of renal stone formation, was noted in all patients on topiramate. CONCLUSIONSIncreasing evidence supports the use of topiramate. Topiramate is generally well tolerated, and serious adverse events are rare. Nonetheless, the present systematic review of the literature indicates that its use is linked with the development of acidosis, hypokalaemia, hyperuricaemia and hypocitraturia.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Metabolic disturbances and renal stone promotion on treatment with topiramate: a systematic review

Dell’Orto

Belotti

Goeggel-Simonetti

et al. 2014

Br J Clin Pharmacol

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“…In late 2012, topiramate was approved by the United States Food and Drug Administration (FDA) in combination with phentermine for weight loss. The drug had previously been used offlabel for this purpose [1][2] . Topiramate was originally produced by Ortho and there was no data from any well-controlled clinical trial to demonstrate that Topamax was safe and effective to treat any psychiatric conditions [3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

Benefit of Topiramate in the Treatment of Symptoms of Borderline Personality Disorder: A Typical Review

Singh¹,

Singh

Patel³

2017

J. Drug Delivery Ther.

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Topiramate is a new antiepileptic drug (AED) that has been approved worldwide (in more than 80 countries) for the treatment of various kinds of epilepsy. It is currently being evaluated for its effect in various neurological and psychiatric disorders. Topiramate is used alone or with other medications to prevent and control seizures (epilepsy). This medication is also used to prevent migraine headaches and decrease how often you get them. The present review includes all available information like pharmacokinetics, pharmacological action and side effects. Moreover sometimes it is necessary to monitor the therapeutic concentration of Topiramate. The pharmacokinetics of topiramate are characterised by linear pharmacokinetics over the dose range 100-800 mg, low oral clearance (22-36 mL/min), which, in immunotherapy, is predominantly through renal excretion (renal clearance 10-20 mL/min), and a long half-life (19-25 hours), which is reduced when co administered with inducing AEDs such as phenytoin, phenobarbital and carbamazepine. This paper provides a critical review of the pharmacokinetic interactions of topiramate with old and new AEDs, an oral contraceptive, and the CNS-active drugs lithium, haloperidol, amitriptyline, risperidone, sumatriptan, propranolol and dihydroergotamine. The results of many of these drug interaction studies with topiramate have not been published before, and are presented and discussed for the first time in this article.

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Current awareness: Pharmacoepidemiology and drug safety

2008

Pharmacoepidemiology and Drug

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In order to keep subscribers up‐to‐date with the latest developments in their field, John Wiley & Sons are providing a current awareness service in each issue of the journal. The bibliography contains newly published material in the field of pharmacoepidemiology and drug safety. Each bibliography is divided into 20 sections: 1 Reviews; 2 General; 3 Anti‐infective Agents; 4 Cardiovascular System Agents; 5 CNS Depressive Agents; 6 Non‐steroidal Anti‐inflammatory Agents; 7 CNS Agents; 8 Anti‐neoplastic Agents; 9 Haematological Agents; 10 Neuroregulator‐Blocking Agents; 11 Dermatological Agents; 12 Immunosuppressive Agents; 13 Autonomic Agents; 14 Respiratory System Agents; 15 Neuromuscular Agents; 16 Reproductive System Agents; 17 Gastrointestinal System Agents; 18 Anti‐inflammatory Agents ‐ Steroidal; 19 Teratogens/fetal exposure; 20 Others. Within each section, articles are listed in alphabetical order with respect to author. If, in the preceding period, no publications are located relevant to any one of these headings, that section will be omitted.

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Hyperventilation and Cerebrospinal Fluid Acidosis Caused by Topiramate

Abstract: Normal doses of topiramate may provoke central neurogenic hyperventilation, as a result of CSF acidosis. The acid-base status of critically ill patients receiving topiramate should be monitored carefully.

Cited by 11 publications

References 15 publications

Metabolic disturbances and renal stone promotion on treatment with topiramate: a systematic review

Metabolic disturbances and renal stone promotion on treatment with topiramate: a systematic review

Benefit of Topiramate in the Treatment of Symptoms of Borderline Personality Disorder: A Typical Review

Current awareness: Pharmacoepidemiology and drug safety

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