TY - JOUR
T1 - Nervous system adverse responses to topiramate in the treatment of neuropsychiatric disorders
AU - Luykx, Jurjen J.
AU - Carpay, Johannes A.
PY - 2010/1/1
Y1 - 2010/1/1
N2 - Importance of the field: Nervous system adverse drug reactions (NS-ADRs), such as cognitive complaints and paresthesia, are among the most frequent and clinically important ADRs of topiramate. Studying ADR profiles across disorders is clinically relevant because treatment decision-making in neuropsychiatry is highly guided by ADR profiles. Areas covered in this review: We used medline searches (until July 2009) to review the NS-ADRs of topiramate across the most investigated topiramate indications: alcohol dependence, essential tremor, binge-eating disorder, bulimia nervosa, migraine and epilepsy. We compared NS-ADRs between these disorders but did not carry out meta-analysis. What the reader will gain: ADR profiles greatly differed between disorders. Drop-outs due to ADRs highly varied between disorders: from 2% in the bulimia nervosa group to 29% in the migraine group. Paresthesia was the most common NS-ADR for all disorders but frequencies also differed between disorders. Cognitive complaints were frequent and were reported in comparable proportions. Take home message: When prescribing topiramate in neuropsychiatry, physicians should be aware that NS-ADR profiles have been found to differ between disorders. Differences in drop-out rates due to ADRs and in frequencies of specific NS-ADRs across disorders must be taken into account when evaluating the potential harm of topiramate in clinical practice.
AB - Importance of the field: Nervous system adverse drug reactions (NS-ADRs), such as cognitive complaints and paresthesia, are among the most frequent and clinically important ADRs of topiramate. Studying ADR profiles across disorders is clinically relevant because treatment decision-making in neuropsychiatry is highly guided by ADR profiles. Areas covered in this review: We used medline searches (until July 2009) to review the NS-ADRs of topiramate across the most investigated topiramate indications: alcohol dependence, essential tremor, binge-eating disorder, bulimia nervosa, migraine and epilepsy. We compared NS-ADRs between these disorders but did not carry out meta-analysis. What the reader will gain: ADR profiles greatly differed between disorders. Drop-outs due to ADRs highly varied between disorders: from 2% in the bulimia nervosa group to 29% in the migraine group. Paresthesia was the most common NS-ADR for all disorders but frequencies also differed between disorders. Cognitive complaints were frequent and were reported in comparable proportions. Take home message: When prescribing topiramate in neuropsychiatry, physicians should be aware that NS-ADR profiles have been found to differ between disorders. Differences in drop-out rates due to ADRs and in frequencies of specific NS-ADRs across disorders must be taken into account when evaluating the potential harm of topiramate in clinical practice.
KW - adverse effect(s)
KW - neuromodulatory drug(s)
KW - neuropsychiatry
KW - Side effect(s)
KW - topiramate
UR - http://www.scopus.com/inward/record.url?scp=77953796076&partnerID=8YFLogxK
U2 - 10.1517/14740331003739196
DO - 10.1517/14740331003739196
M3 - Review article
C2 - 20367527
AN - SCOPUS:77953796076
SN - 1474-0338
VL - 9
SP - 623
EP - 631
JO - Expert Opinion on Drug Safety
JF - Expert Opinion on Drug Safety
IS - 4
ER -