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Year : 2020  |  Volume : 58  |  Issue : 1  |  Page : 58

Topiramate features: Mnemonic

Department of Neurology, Department of Medicine, Federal University of Santa Maria, Santa Maria, Rio Grande do Sul, Brazil

Date of Submission16-Nov-2019
Date of Acceptance18-Nov-2019
Date of Web Publication04-Mar-2020

Correspondence Address:
Mr. Jamir Pitton Rissardo
Rua Roraima, Santa Maria, Rio Grande do Sul
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tjosr.tjosr_111_19

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How to cite this article:
Rissardo JP, Fornari Caprara AL. Topiramate features: Mnemonic. TNOA J Ophthalmic Sci Res 2020;58:58

How to cite this URL:
Rissardo JP, Fornari Caprara AL. Topiramate features: Mnemonic. TNOA J Ophthalmic Sci Res [serial online] 2020 [cited 2020 Jul 13];58:58. Available from: http://www.tnoajosr.com/text.asp?2020/58/1/58/279996

We read the article entitled “Aftermath of Topiramate: An Interesting Case Report and Literature Review” on the esteemed “TNOA Journal of Ophthalmic Science and Research” with great interest. Senthilkumar and Rajendrababu reported a patient presenting with bilateral secondary acute angle-closure glaucoma (ACG) with glaukomflecken secondary to topiramate.[1]

Here, we would like to provide the mnemonic “TOPIRAMATE” to help remember the main facts associated with topiramate:[1],[2],[3],[4],[5],[6]

  • Transient myopic shift normally recovery within 2 weeks
  • O (U): Urolithiasis by carbonic anhydrase inhibition (CAi)
  • Perioral and peripheral paresthesias are the most common side effects reported by patients and probably associated with low potassium levels due to CAI
  • It inhibits CYP 2C19 weak and is induced by phenytoin and carbamazepine
  • It reduces high-voltage calcium currents (L-type) and also acts in NMDA channels
  • ACG with glaukomflecken and the patient also could develop posterior and anterior synechiae
  • Memory impairment and difficulty concentrating and reversible after withdrawal in the majority of the patients
  • Acute ACG and panuveitis due to hapten hypothesis inciting immune misleading process
  • Teratogenic with urogenital malformations and cleft lip and palate
  • Effusions from the uveal region.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Senthilkumar VA, Rajendrababu S. Aftermath of topiramate: An interesting case report and literature review. TNOA J Ophthalmic Sci Res 2019;57:240.  Back to cited text no. 1
  [Full text]  
Abtahi MA, Abtahi SH, Fazel F, Roomizadeh P, Etemadifar M, Jenab K, et al. Topiramate and the vision: A systematic review. Clin Ophthalmol 2012;6:117-31.  Back to cited text no. 2
Fraunfelder FW, Fraunfelder FT, Keates EU. Topiramate-associated acute, bilateral, secondary angle-closure glaucoma. Ophthalmology 2004;111:109-11.  Back to cited text no. 3
Garnett WR. Clinical pharmacology of topiramate: A review. Epilepsia 2000;41 Suppl 1:S61-5.  Back to cited text no. 4
Sankar PS, Pasquale LR, Grosskreutz CL. Uveal effusion and secondary angle-closure glaucoma associated with topiramate use. Arch Ophthalmol 2001;119:1210-1.  Back to cited text no. 5
Shank RP, Gardocki JF, Streeter AJ, Maryanoff BE. An overview of the preclinical aspects of topiramate: Pharmacology, pharmacokinetics, and mechanism of action. Epilepsia 2000;41 Suppl 1:S3-9.  Back to cited text no. 6


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