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Topiramate and Death
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Q: I am interested in learning about Topamax, but I have seen some warnings about deaths being possible related to it. Do you have any information regarding this? The only information I saw at your site [Dr. Ivan's, she's referring to] regarding Topamax and death was for overdosing on the medication. Hello Lisa
Anticonvulsant hypersensitivity syndrome, a potentially fatal but rare reaction, manifests as rash, fever, tender lymphadenopathy, hepatitis, and eosinophilia. To manage hypersensitivity syndrome successfully, one must recognize the symptoms early, stop the offending drug immediately, and substitute a safe, alternative anticonvulsant medication. Hypersensitivity syndrome has not been described in patients taking benzodiazepines or the newer anticonvulsants gabapentin or topiramate, and these appear to be safe substitutes for drugs that cause the reaction.Another search using Google for "topiramate death" yielded this list of adverse events. Note that this is the part of the list that refers to events occurring at less than 1% frequency, with no placebo comparison of frequency. That means you don't really know whether "sudden death", which is on the list as "rare", is from topiramate or not -- people do just keel over now and then, unfortunately, even on no med's. The link for the whole text of what follows is http://www.rxlist.com/cgi/generic2/topiram_ad.html . Other Adverse Events Observed During All Clinical TrialsThere -- now you know as much as any psychiatrist whom you might see would know. Try those approaches to get similar information on other drugs in the future. Dr. Phelps |