Topiramate overdosage

Topiramate
TOPIRAMATE® FDA Package Insert
Indications and Usage
Dosage and Administration
Dosage Forms and Strengths
Contraindications
Warnings and Precautions
Adverse Reactions
Drug Interactions
Use in Specific Populations
Overdosage
Description
Clinical Pharmacology
Nonclinical Toxicology
Clinical Studies
How Supplied/Storage and Handling
Patient Counseling Information
Labels and Packages
Clinical Trials on Topiramate
ClinicalTrials.gov

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Pratik Bahekar, MBBS [2]

For patient information about topiramate, click here.

Drug Abuse and Dependence

Controlled Substance

Topiramate is not a controlled substance.

Abuse

The abuse and dependence potential of topiramate has not been evaluated in human studies.

Dependence

Topiramate has not been systematically studied in animals or humans for its potential for tolerance or physical dependence.

Overdosage

Overdoses of topiramate have been reported. Signs and symptoms included convulsions, drowsiness, speech disturbance, blurred vision, diplopia, mentation impaired, lethargy, abnormal coordination, stupor, hypotension, abdominal pain, agitation, dizziness, and depression. The clinical consequences were not severe in most cases, but deaths have been reported after poly-drug overdoses involving topiramate.

Topiramate overdose has resulted in severe metabolic acidosis [see Warnings and Precautions (5.3)].

A patient who ingested a dose between 96 and 110 g topiramate was admitted to a hospital with a coma lasting 20 to 24 hours followed by full recovery after 3 to 4 days.

In acute topiramate overdose, if the ingestion is recent, the stomach should be emptied immediately by lavage or by induction of emesis. Activated charcoal has been shown to adsorb topiramate in vitro. Treatment should be appropriately supportive. Hemodialysis is an effective means of removing topiramate from the body.

Symptoms of overdose may include but are not limited to:

• Seizures
• Dizziness, drowsiness, tiredness
• Agitation
• Depression
• Speech problems
• Blurred vision, double vision
• Troubled thinking
• Loss of coordination
• Inability to respond to things around you
• Loss of consciousness
• Confusion and coma
• Fainting
• Upset stomach and stomach pain
• Loss of appetite and vomiting
• Excessive hunger
• Shortness of breath; fast, shallow breathing
• Pounding or irregular heartbeat
• Muscle weakness
• Bone pain

A specific antidote is not available. Treatment is entirely symptomatic.

References

Adapted from the FDA Package Insert.