Neutropenia Associated With Topiramate Monotherapy: Adverse Effects Associated With Topiramate Usage

Abstract

Topiramate is a well-known anti-epileptic drug and used in the migraine prophylaxis. Topiramate has various effects on different receptors and enzymes. Beholding the result, drug has many central nervous system (CNS)-related and systemic adverse effects. It has also hematopoietic adverse effects, but these effects are very rare and associated with previous or concomitant use of sulfonamides which inhibit carbonic anhydrase. A 33-year-old female patient who had migraine without aura diagnosis for nearly 13 years was admitted to outpatient clinic with symptoms of nausea, fatigue and malaise. She had no medication except for eletriptan (40 mg during attack) which was introduced to her 5 months ago and topiramate (100 mg/day) which was introduced 5 weeks ago with a dose of 25 mg/day and escalated to current dose in 4 weeks. Complete blood cell count revealed low white blood cells and low neutrophil. We presented a case which had a clinically important hematologic adverse reaction associated with newly introduced topiramate treatment without any previous or concurrent sulfonamide usage. Topiramate is a sulfa-derivative monosaccharide that is used for treating epilepsy (1996) and migraine (2004), but other indications include infantile spasms, psychiatric disorders, neuropathic pain, weight reduction, tobacco dependence, essential tremor and post-herpetic neuralgia. Topiramate, one of these novel anti-epileptic drugs, is associated with hematologic adverse reactions. According to our knowledge, this report of hematologic adverse effects associated with topiramate without previous or concurrent usage of sulfonamides is first in the literature.




J Neurol Res. 2015;5(4-5):264-266
doi: http://dx.doi.org/10.14740/jnr353w